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

There is increasing focus on adjunctive anesthesia to reduce complications and improve pain control among surgical patients. This study aims to investigate and compare if the type of anesthesia (spinal, transversus abdominis plane [TAP] block, or general anesthesia alone) used in patients undergoing colorectal surgery within an Enhanced Recovery After Surgery protocol is associated with improved patient outcomes.

This retrospective cohort study analyzed adult patients undergoing colorectal surgery at a Regional Hospital from December 2019 to October 2021. Data on demographics, operative details, complications, postoperative outcomes, and compliance were collected. The primary outcome was the association of adjunctive anesthesia on postoperative outcomes. After association analysis, variables yielding P < 0.10 associated with the primary or secondary outcomes were chosen for regression analysis, with calculation of univariable odds ratios (ORs) and a significance set at P < 0.05.

Among 225 patients, 70 received a TAP block, 100 spinal anesthesia, and 55 general anesthesia. There were no differences in length of stay (P = 0.746), readmission (P = 0.144), bowel function (0.778), complications (P = 0.24), or pain control (P = 0.686). Spinal anesthesia was associated with higher oral intake in postanesthesia recovery unit (OR 5.3750, P < 0.001), lower narcotic use (OR 0.4303, P = 0.0213), and fewer discharges to skilled nursing facilities (OR 0.0303, P = 0.018).

Spinal anesthesia is associated with improved oral intake, reduced narcotic use, and less skilled nursing facility discharge in colorectal surgery patients compared to TAP blocks and general anesthesia.