Epidural analgesia (EA) with local anaesthetic is considered to play a key role after colorectal surgery.
However, its effect on post-operative recovery is still a matter of debate.
Dr E. Marret and colleagues created a systematic review of randomized controlled trials comparing post-operative EA and parenteral opioid analgesia after colorectal surgery.
| EA did not influence the duration of hospital stays |
| British Journal of Surgery |
The effect on postoperative recovery was evaluated in terms of length of hospital stay, pain intensity, duration of post-operative ileus, incidence of post-operative complications and side-effects.
16 trials published between 1987 and 2005 were included.
EA significantly reduced pain scores and duration of ileus (weighted mean difference - 1•55 (95 per cent confidence interval (c.i.) - 2•27 to - 0•84) days).
On the other hand, it was associated with a significant increase in the incidence of pruritus (odds ratio (OR) 4•8 (95 per cent c.i. 1•3 to 17•0)), urinary retention (OR 4•3 (1•2 to 15•9)) and arterial hypotension (OR 13•5 (4•0 to 57•7)).
EA did not influence duration of hospital stay.
Dr Marret concluded that, "Despite improved analgesia and a decrease in ileus, EA has some adverse effects and does not shorten the duration of hospital stay after colorectal surgery".