SynthesisSurgical endoscopy2013
Effect of epidural analgesia on bowel function in laparoscopic colorectal surgery: a systematic review and meta-analysis.
Synthesis in Surgical endoscopy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Low intra-abdominal pressure and deep neuromuscular blockade laparoscopic surgery and surgical space conditions: A meta-analysis.Medicine · 2020Pooled it
- Thoracic epidural analgesia (TEA) versus patient-controlled analgesia (PCA) in laparoscopic colectomy: a systematic review and meta-analysis.International journal of colorectal disease · 2019Pooled it
- Fast-track surgery versus traditional perioperative care in laparoscopic colorectal cancer surgery: a meta-analysis.BMC cancer · 2014Pooled it
- Real-time ultrasound-guided versus landmark techniques for thoracic epidural placement in elderly patients: A randomized comparative study.Scientific reports · 2026Trial
- Trial
- Comparison of the effects of patient-controlled epidural and intravenous analgesia on postoperative bowel function after laparoscopic gastrectomy: a prospective randomized study.Surgical endoscopy · 2017Trial
- Trial
- Pain in Colorectal Surgery: How Does It Occur and What Tools Do We Have for Treatment?Journal of clinical medicine · 2023Review
- Necessity of routine perioperative epidural catheter placement in laparoscopic colorectal resections: a retrospective data analysis.Langenbeck's archives of surgery · 2023Article
- Postoperative analgesia for upper gastrointestinal surgery: a retrospective cohort analysis.Perioperative medicine (London, England) · 2023Article
- ERAS Protocol Options for Perioperative Pain Management of Substance Use Disorder in the Ambulatory Surgical Setting.Current pain and headache reports · 2023Review
- Laparoscopic rectal resection without epidural catheters-does it work?International journal of colorectal disease · 2022Article
- Intrathecal diamorphine for perioperative analgesia during colorectal surgery: a cross-sectional survey of current UK practice.BMJ open · 2022Article
- Purely ropivacaine-based TEA vs single TAP block in pain management after elective laparoscopic colon surgery within an upgraded institutional ERAS program.Surgical endoscopy · 2022Article
- Article
- Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review.Annals of medicine and surgery (2012) · 2021Review
- Association of Perioperative Regional Analgesia with Postoperative Patient-Reported Pain Outcomes and Opioid Requirements: Comparing 22 Different Surgical Groups in 23,911 Patients from the QUIPS Registry.Journal of clinical medicine · 2021Article
- Influence of the Enhanced Recovery After Surgery Protocol on Postoperative Inflammation and Short-term Postoperative Surgical Outcomes After Colorectal Cancer Surgery.Annals of coloproctology · 2020Article
- Postoperative Ileus and Postoperative Gastrointestinal Tract Dysfunction: Pathogenic Mechanisms and Novel Treatment Strategies Beyond Colorectal Enhanced Recovery After Surgery Protocols.Frontiers in pharmacology · 2020Review
- Early removal of urinary drainage in patients receiving epidural analgesia after colorectal surgery within an ERAS protocol is feasible.Langenbeck's archives of surgery · 2019Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeUse of thoracic epidural analgesia (TEA) with local anesthetic and adjuncts, such as opioids, are cornerstones of ERAS (Enhanced Recovery After Surgery) and are considered to play a key role in recovery after colorectal surgery. However, its effect on bowel function may lead to prolong hospital stay and is still a matter of debate. The purpose of this systemic review was to assess whether epidural analgesia could have a detrimental effect on bowel function in laparoscopic colorectal surgery with a subsequent effect on hospital stay duration, leading to failure of ERAS in colorectal surgery.
methodsA systematic review of randomized, controlled trials for the effect of epidural analgesia on laparoscopic colorectal surgery was performed. The effect on postoperative recovery was evaluated in terms of return of bowel function as the primary outcome, whereas length of stay (LOS), pain score on visual analogue scale, operative time, and incidence of postoperative complications and side-effects of analgesia were recorded as secondary outcomes.
resultsSix trials published between 1999 and 2011 were included in the final analysis. TEA significantly improves return of bowel function assessed by time to first bowel motion [WMD -0.62 (-1.11, -0.12) with Z = 2.43; P = 0.02, 95 % confidence interval (CI)], and pain scores [WMD -1.23 (-2.4, -0.07)] with Z = 2.07; P = 0.04, 95 % CI]. TEA did not influence duration of hospital stay [WMD -0.47 (-1.55, 0.61)] with Z = 0.85 (P = 0.39, 95 % CI). No significant increase in operative time or side effects was associated with TEA.
conclusionsDespite of some beneficial effect of epidural analgesia on return of bowel function and pain in laparoscopic surgery, it does not affect LOS, which is multifactorial.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.