ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2013
A nationwide analysis of the use and outcomes of epidural analgesia in open colorectal surgery.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
17 citing papers in PubMed, 33 citations in OpenAlex.
- Effect of Pharmacoprophylaxis on Postoperative Outcomes in Adult Elective Colorectal Surgery: A Multi-Center Retrospective Cohort Study within an Enhanced Recovery after Surgery Framework.Healthcare (Basel, Switzerland) · 2023Article
- Necessity of routine perioperative epidural catheter placement in laparoscopic colorectal resections: a retrospective data analysis.Langenbeck's archives of surgery · 2023Article
- Thoracic epidural analgesia vs. patient-controlled intravenous analgesia for patients undergoing open or laparoscopic colorectal cancer surgery: An observational study.European journal of anaesthesiology and intensive care · 2023Article
- 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
- Enhancing Recovery After Kasai Portoenterostomy With Epidural Analgesia.The Journal of surgical research · 2019Article
- Epidural analgesia in the era of enhanced recovery: time to rethink its use?Surgical endoscopy · 2019Article
- Use of Epidural Analgesia in Sigmoidectomy: Is There Any Advantage in the Era of Minimally Invasive Surgery?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Observational
- Effects of epidural analgesia on recovery after open colorectal surgery.Proceedings (Baylor University. Medical Center) · 2017Article
- Observational
- Opioid-sparing effect of selective cyclooxygenase-2 inhibitors on surgical outcomes after open colorectal surgery within an enhanced recovery after surgery protocol.World journal of gastrointestinal oncology · 2016Article
- A nationwide analysis of the use and outcomes of perioperative epidural analgesia in patients undergoing hepatic and pancreatic surgery.American journal of surgery · 2015Article
- Pain control for laparoscopic colectomy: an analysis of the incidence and utility of epidural analgesia compared to conventional analgesia.Techniques in coloproctology · 2015Article
- Robotic general surgery: current practice, evidence, and perspective.Langenbeck's archives of surgery · 2015Review
- Evaluation of epidural analgesia for open major liver resection surgery from a US inpatient sample.Proceedings (Baylor University. Medical Center) · 2014Article
- Reducing the burden of postoperative ileus: evaluating and implementing an evidence-based strategy.World journal of surgery · 2014Review
- Differences in perioperative care at low- and high-mortality hospitals with cancer surgery.Annals of surgical oncology · 2014Article
- The impact of anesthesia on postoperative outcomes: the effect of regional anesthesia on the incidence of surgical site infections.Brazilian journal of anesthesiology (Elsevier)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionEpidural analgesia has demonstrated superiority over conventional analgesia in controlling pain following open colorectal resections. Controversy exists regarding cost-effectiveness and postoperative outcomes.
methodsThe Nationwide Inpatient Sample (2002-2010) was retrospectively reviewed for elective open colorectal surgeries performed for benign and malignant conditions with or without the use of epidural analgesia. Multivariate regression analysis was used to compare outcomes between epidural and conventional analgesia.
resultsA total 888,135 patients underwent open colorectal resections. Epidural analgesia was only used in 39,345 (4.4 %) cases. Epidurals were more likely to be used in teaching hospitals and rectal cancer cases. On multivariate analysis, in colonic cases, epidural analgesia lowered hospital charges by US$4,450 (p < 0.001) but was associated with longer length of stay by 0.16 day (p < 0.05) and a higher incidence of ileus (OR = 1.17; p < 0.01). In rectal cases, epidural analgesia was again associated with lower hospital charges by US$4,340 (p < 0.001) but had no effect on ileus and length of stay. The remaining outcomes such as mortality, respiratory failure, pneumonia, anastomotic leak, urinary tract infection, and retention were unaffected by the use of epidurals.
conclusionEpidural analgesia in open colorectal surgery is safe but does not add major clinical benefits over conventional analgesia. It appears however to lower hospital charges.
Indexed as
Identifiers
What OpenQuestion holds
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.