TY - JOUR
T1 - Evidence-based postoperative pain management after laparoscopic colorectal surgery
AU - Joshi, G P
AU - Bonnet, F
AU - Kehlet, H
AU - on behalf of the PROSPECT collaboration
N1 - © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.
PY - 2013/2/1
Y1 - 2013/2/1
N2 - Aim The aim of this systematic review was to evaluate the available literature on the management of pain after laparoscopic colorectal surgery. Method Randomized studies, published in English between January 1995 and July 2011, assessing analgesic and anaesthetic interventions in adults undergoing laparoscopic colorectal surgery, and reporting pain scores, were retrieved from the Embase and MEDLINE databases. The efficacy and adverse effects of the analgesic techniques was assessed. The recommendations were based on procedure-specific evidence from a systematic review and supplementary transferable evidence from other relevant procedures. Results Of the 170 randomized studies identified, 12 studies were included. Overall, all approaches including ketorolac, methylprednisolone, intraperitoneal instillation of ropivacaine, intravenous lidocaine infusion, intrathecal morphine and epidural analgesia improved pain relief, reduced opioid requirements and improved bowel function. However, there were significant differences in the study designs and the variables evaluated, precluding quantitative analysis. The L'Abbé plots of the data from the epidural analgesia studies included in this review indicate that the pain scores in the nonepidural groups, although higher than those in the epidural groups, were within an acceptable level (i.e.
AB - Aim The aim of this systematic review was to evaluate the available literature on the management of pain after laparoscopic colorectal surgery. Method Randomized studies, published in English between January 1995 and July 2011, assessing analgesic and anaesthetic interventions in adults undergoing laparoscopic colorectal surgery, and reporting pain scores, were retrieved from the Embase and MEDLINE databases. The efficacy and adverse effects of the analgesic techniques was assessed. The recommendations were based on procedure-specific evidence from a systematic review and supplementary transferable evidence from other relevant procedures. Results Of the 170 randomized studies identified, 12 studies were included. Overall, all approaches including ketorolac, methylprednisolone, intraperitoneal instillation of ropivacaine, intravenous lidocaine infusion, intrathecal morphine and epidural analgesia improved pain relief, reduced opioid requirements and improved bowel function. However, there were significant differences in the study designs and the variables evaluated, precluding quantitative analysis. The L'Abbé plots of the data from the epidural analgesia studies included in this review indicate that the pain scores in the nonepidural groups, although higher than those in the epidural groups, were within an acceptable level (i.e.
U2 - 10.1111/j.1463-1318.2012.03062.x
DO - 10.1111/j.1463-1318.2012.03062.x
M3 - Journal article
C2 - 23350836
SN - 1462-8910
VL - 15
SP - 146
EP - 155
JO - Colorectal Disease
JF - Colorectal Disease
IS - 2
ER -