ArticleSurgical endoscopy2015
Comprehensive enhanced recovery pathway significantly reduces postoperative length of stay and opioid usage in elective laparoscopic colectomy.
Article in Surgical endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 15 papers.
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.
A Prospective Pilot Study of a Non-Narcotic Post-Operative Course After Colectomy
Liposomal Bupivacaine/Bupivacaine A Single-Dose Bilateral Rectus Sheath Blocks Versus Ropivacaine in Bilateral Rectus Sheath Blocks And Catheters With Intermittent Hourly Boluses.
Who cites it
15 citing papers in PubMed.
- Continuous Transversus Abdominis Plane Blocks via Laparoscopically Placed Catheters for Bariatric Surgery.Obesity surgery · 2017Trial
- Predictors of persistent postoperative opioid use following colectomy: a population-based cohort study from England.Anaesthesia · 2023Article
- Smoking Cessation for Preoperative Optimization.Clinics in colon and rectal surgery · 2023Review
- Prescribing Narcotics for Pain: Reconsider the Fifth Vital Sign.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Article
- Exploring Non-pharmacological Methods for Pre-operative Pain Management.Frontiers in surgery · 2022Review
- Perioperative factors associated with pain following open ventral hernia repair.Surgical endoscopy · 2019Article
- Associated factors with delayed ambulation after abdominal surgery.Journal of anesthesia · 2019Article
- Educating Surgical Oncology Providers on Perioperative Opioid Use: Results of a Departmental Survey on Perceptions of Opioid Needs and Prescribing Habits.Annals of surgical oncology · 2019Article
- Article
- Ultrasound-guided subcostal transversus abdominis plane block with liposomal bupivacaine compared to bupivacaine infiltration for patients undergoing robotic-assisted and laparoscopic hysterectomy: a prospective randomized study.Journal of pain research · 2019Article
- Impact of laparoscopy on adherence to an enhanced recovery pathway and readiness for discharge in elective colorectal surgery: Results from the PeriOperative Italian Society registry.Surgical endoscopy · 2017Article
- Clinical practice guideline for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons (ASCRS) and Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).Surgical endoscopy · 2017Article
- Effect of Preoperative Opioid Exposure on Healthcare Utilization and Expenditures Following Elective Abdominal Surgery.Annals of surgery · 2017Article
- The Use of Opioid Analgesics following Common Upper Extremity Surgical Procedures: A National, Population-Based Study.Plastic and reconstructive surgery · 2016Article
- Efficacy of laparoscopic transversus abdominis plane block for elective laparoscopic cholecystectomy in elderly patients.Bosnian journal of basic medical sciences · 2016Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA comprehensive enhanced recovery pathway (ERP) was implemented in patients undergoing laparoscopic colectomy in an attempt to reduce postoperative opioid consumption. We hypothesized that improved local analgesia and increased use of non-opioid pain medication, combined with earlier feeding and ambulation, would allow for earlier return of bowel function and shorter postoperative length of stay (LOS).
methodsWe retrospectively reviewed 89 patients who underwent elective partial laparoscopic colectomy with our ERP fully integrated compared to a historical control group of 162 patients. Differences between the ERP and control groups average return of bowel function, postoperative LOS, opioid medication usage, and complications were compared statistically using the student's t-test and Fisher exact test. Pain was controlled with the laparoscope-guided transversus abdominis plane (TAP), scheduled doses of non-narcotic medications, and reserved use of opioids. Patient, nursing and resident education regarding all aspects of the ERP was emphasized.
resultsPatients in the ERP group had a significant decrease of opioid usage, earlier return of bowel function, and shorter postoperative hospital LOS. Opioid use was reduced from 75 to 19 mg I.V. morphine (p = 0.0001). Patients had an average return of bowel function of 0.66 days earlier from postoperative day (POD) 2.99 to POD 2.33 (p = 0.0001) and were discharged from the hospital 1 day sooner on POD 2.7 compared with POD 3.7 (p = 0.0013). There was no statistically significant difference in postoperative complications between the control and ERP groups.
conclusionThe new ERP, including TAP block and postoperative pain medication protocol limiting I.V. narcotics, is effective in controlling pain in elective partial laparoscopic colectomy. Pain control management together with regimented early feeding and ambulation allow for significantly earlier return of bowel function and shorter postoperative LOS.
Indexed as
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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.