World Journal of Laparoscopic Surgery

Register      Login

VOLUME 1 , ISSUE 3 ( September-December, 2008 ) > List of Articles


Thoracic Epidural versus Morphine Patient Controlled Analgesia After Laparoscopic Colectomy

RJ Dennis, P Mills

Citation Information : Dennis R, Mills P. Thoracic Epidural versus Morphine Patient Controlled Analgesia After Laparoscopic Colectomy. World J Lap Surg 2008; 1 (3):49-52.

DOI: 10.5005/jp-journals-10007-1071

Published Online: 01-04-2011

Copyright Statement:  Copyright © 2008; The Author(s).


Despite the benefits of the laparoscopic approach to colorectal surgery patients still experience significant levels of pain post- operatively. This study aimed to compare the use of thoracic epidural vs. morphine patient controlled analgesia in the management of pain after laparoscopic colorectal surgery. A retrospective analysis of hospital records was performed for 16 patients undergoing laparoscopic colorectal surgery (8 thoracic epidural, 8 patient controlled analgesia). Visual rating scale pain scores (0 – 10) were significantly lower for patients managed with thoracic epidural in recovery (mean [95% CI]) (0 vs. 5.3 [3.6-6.9]), at 6 hours (1 [0-2.0] vs. 5.4 [4.2-6.5]), 12 hours (0.4 [0-1.1] vs. 4.4 [3.3-5.4]) and 24 hours (1.3 [0-2.8] vs. 5.9 [4.9- 6.9]). Thoracic epidural offers the optimal analgesia and quality of care to the patient following laparoscopic colectomy.

PDF Share
  1. Systemic cytokine response after laparoscopic-assisted resection of rectosigmoid carcinoma: a prospective randomized trial. Annals Surgery 2000;231:506-11.
  2. A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. Journal of the American College of Surgeons 1998;187:46-55.
  3. Postoperative pain and fatigue after laparoscopic or conventional colorectal resections: a prospective randomized trial. Surgical Endoscopy 1998;12:1131-36.
  4. Clinical Outcomes of Surgical Therapy (COST) Study Group. Shortterm quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. The Journal of the American Medical Association 2002;287:321-28.
  5. Patient controlled intravenous opioid analgesia versus continuous epidural analgesia for pain after intra-abdominal surgery. Cochrane Database of Systematic Reviews 2005;CD004088.
  6. Randomized clinical trial comparing epidural anaesthesia and patient-controlled analgesia after laparoscopic segmental colectomy. British Journal Surgery 2003;90:1195-99.
  7. Thoracic epidural analgesia facilitates the restoration of bowel function and dietary intake in patients undergoing laparoscopic colon resection using a traditional, nonaccelerated, perioperative care program. Surg Endosc 2007;2:247-52.
  8. Epidural Anesthesia and Analgesia. Their Role in Postoperative Outcome. Anesthesiology 1995;82:1474-1506.
  9. Effects of perioperative analgesic technique on rate of recovery after colon surgery. anesthesiology 1995;83:757-65.
  10. Interleukin-6 response to laparoscopic and open colectomy. Diseases of the Colon and Rectum 1994;37:754-59.
  11. Epidural anaesthesiaanalgesia shortens length of stay after laparoscopic segmental colectomy for benign pathology. Surgery 2001;129:672-76.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.