Comparison of Adjunctive Anesthesia Within an ERAS Protocol: A Retrospective Cohort Study

Area of Science:

• Anesthesiology
• Surgical Outcomes
• Colorectal Surgery

Background:

• Adjunctive anesthesia is increasingly used to improve pain control and reduce complications in surgical patients.
• Enhanced Recovery After Surgery (ERAS) protocols aim to optimize patient recovery.
• The comparative effectiveness of different anesthesia types within ERAS protocols requires further investigation.

Purpose of the Study:

• To compare the effectiveness of spinal anesthesia, transversus abdominis plane (TAP) block, and general anesthesia alone in colorectal surgery patients.
• To investigate the association of anesthesia type with postoperative outcomes within an ERAS protocol.

Main Methods:

• Retrospective cohort study of 225 adult patients undergoing colorectal surgery between December 2019 and October 2021.
• Collected data included demographics, operative details, complications, and postoperative outcomes.
• Compared outcomes across spinal anesthesia, TAP block, and general anesthesia groups, with regression analysis for significant variables.

Main Results:

• No significant differences were observed in length of stay, readmission rates, bowel function, overall complications, or pain control.
• Spinal anesthesia was associated with significantly higher oral intake (OR 5.3750, P < 0.001).
• Spinal anesthesia also correlated with lower narcotic use (OR 0.4303, P = 0.0213) and fewer discharges to skilled nursing facilities (OR 0.0303, P = 0.018).

Conclusions:

• Spinal anesthesia demonstrates superior outcomes in specific areas compared to TAP block and general anesthesia in colorectal surgery.
• Improved oral intake and reduced narcotic requirements are key benefits associated with spinal anesthesia.
• Spinal anesthesia may contribute to decreased need for skilled nursing facility placement post-surgery.