Evidence map›Paper›PMID 41573456›Full record

ArticleCureus2025

Goal-Directed Fluid Therapy and Perioperative Epidural Analgesia in Low-Risk Patients Undergoing Elective Colorectal Surgery: Short-Term Clinical Outcomes From a Retrospective-Prospective Cohort Study.

Agathi Karakosta, Evangelia Kaminioti, Maria Riga, Panagiotis Briassoulis, Aggeliki Pantazi, Tatiana Sidiropoulou, Petros Tzimas, Georgia G Kostopanagiotou

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In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Agathi KarakostaDepartment of Anesthesiology, University Hospital of Ioannina, Faculty of Medicine, University of Ioannina, Ioannina, GRC.
Evangelia KaminiotiSecond Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Maria RigaSecond Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Panagiotis BriassoulisSecond Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Aggeliki PantaziSecond Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Tatiana SidiropoulouSecond Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Petros TzimasDepartment of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, GRC.
Georgia G KostopanagiotouSecond Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Enhanced Recovery After Surgery (ERAS) protocols emphasize perioperative fluid management to optimize outcomes following major abdominal surgery. This study aimed to investigate the effect of thoracic epidural analgesia on hospital length of stay in low-risk patients undergoing open elective colorectal surgery managed with goal-directed fluid therapy (GDFT). A retrospective-prospective single-center cohort study was conducted, enrolling low-risk (American Society of Anesthesiologists (ASA) I-II) patients scheduled for open elective colorectal surgery. Forty-nine patients were prospectively assigned to either GDFT with intravenous analgesia (GDFT group) or GDFT with epidural analgesia (GDFT/ED group). Additionally, 72 patient records managed with conventional fluid therapy (CFT), with (CFT/ED group) or without epidural analgesia (CFT group), were retrospectively reviewed. The primary outcome was length of hospital stay; secondary outcomes included intraoperative fluid administration, gastrointestinal recovery, pro-B-type natriuretic peptide (BNP) levels, and in-hospital mortality. Overall analysis showed shorter hospital stay across groups, which did not reach statistical significance (p=0.08), while pairwise comparison demonstrated significantly shorter stay in the GDFT/ED group compared with the CFT group (p=0.048). Gastrointestinal recovery did not differ significantly between groups, although ileus was more frequent in the CFT and CFT/ED groups. Total intraoperative fluid administration was significantly lower in GDFT-managed patients (p=0.006), with no significant difference between the GDFT and GDFT/ED groups. Baseline and postoperative proBNP levels were comparable across groups, and no in-hospital deaths occurred. In conclusion, among low-risk patients undergoing major open elective colorectal surgery, combining GDFT with thoracic epidural analgesia was associated with a trend toward shorter hospital stay. These findings support integrating individualized fluid optimization with effective analgesia within ERAS protocols even for low-risk patients.

Indexed as

colorectal surgeryenhanced recoveryepidural analgesiagoal directed fluid therapylength of hospital staylow-risk patients

Identifiers

PMID41573456
PMCPMC12821076

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