Observational studyDiseases of the colon and rectum2018
Thoracic Epidural Analgesia: Does It Enhance Recovery?
Observational study in Diseases of the colon and rectum, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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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.
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Who cites it
10 citing papers in PubMed, 27 citations in OpenAlex.
- ROUX-IN-Y GASTROJEJUNAL BYPASS: WHICH ANESTHETIC TECHNIQUE HAS BEST RESULTS?Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2021Trial
- Improving Perioperative Care in Gastric Surgery: Insights from the EUropean PErioperative MEdical Networking (EUPEMEN) Project.Journal of clinical medicine · 2025Article
- Postoperative Multimodal Analgesia Strategy for Enhanced Recovery After Surgery in Elderly Colorectal Cancer Patients.Pain and therapy · 2024Review
- The association of regional block with intraoperative opioid consumption in patients undergoing video-assisted thoracoscopic surgery: a single-center, retrospective study.Journal of cardiothoracic surgery · 2024Article
- Effect of single-shot intrathecal morphine versus continuous epidural analgesia on length of stay after gastrectomy for cancer: a retrospective cohort study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2023Article
- The clinical impact of the perioperative epidural anesthesia on surgical outcomes after pancreaticoduodenectomy: A retrospective cohort study.Surgery open science · 2022Article
- State-of-the-art colorectal disease: postoperative ileus.International journal of colorectal disease · 2021Review
- Feasibility assessment of outpatient colorectal resections at a tertiary referral center.International journal of colorectal disease · 2021Article
- Postoperative Complications After Colorectal Surgery: Where Are We in the Era of Enhanced Recovery?Current gastroenterology reports · 2020Review
- Postoperative Thoracic Epidural Analgesia: Adverse Events from a Single-Center Series of 3126 Patients.Local and regional anesthesia · 2020Article
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThoracic epidural analgesia has been shown to be an effective method of pain control. The utility of epidural analgesia as part of an enhanced recovery after surgery protocol is debatable.
objectiveThis study aimed to determine if the use of thoracic epidural analgesia in an enhanced recovery after surgery protocol decreases hospital length of stay or inpatient opioid consumption after elective colorectal resection.
designThis is a single-institution retrospective cohort study. SETTINGS: The study was performed at a high-volume, tertiary care center in the Midwest. An institutional database was used to identify patients. PATIENTS: All patients undergoing elective transabdominal colon or rectal resection by board-certified colon and rectal surgeons from 2013 to 2017 were included.
main outcome measuresThe main outcome was length of stay. The secondary outcome was oral morphine milligram equivalents consumed during the first 48 hours.
resultsThere were 1006 patients (n = 815 epidural, 191 no epidural) included. All patients received multimodal analgesia with opioid-sparing agents. Univariate analysis demonstrated no difference in length of stay between those who received thoracic epidural analgesia and those who did not (median, 4 vs 5 days; p = 0.16), which was substantiated by multivariable linear regression. Subgroup analysis showed that the addition of epidural analgesia resulted in no difference in length of stay regardless of an open (n = 362; p = 0.66) or minimally invasive (n = 644; p = 0.46) approach. Opioid consumption data were available after 2015 (n = 497 patients). Univariate analysis demonstrated no difference in morphine milligram equivalents consumed in the first 48 hours between patients who received epidural analgesia and those who did not (median, 135 vs 110 oral morphine milligram equivalents; p = 0.35). This was also confirmed by multivariable linear regression. LIMITATIONS: The retrospective observational design was a limitation of this study.
conclusionThe use of thoracic epidural analgesia within an enhanced recovery after surgery protocol was not found to be associated with a reduction in length of stay or morphine milligram equivalents consumed within the first 48 hours. We cannot recommend routine use of thoracic epidural analgesia within enhanced recovery after surgery protocols. See Video Abstract at http://links.lww.com/DCR/A765.
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