Short-term outcomes with intrathecal versus epidural analgesia in laparoscopic colorectal surgery

Abstract

Abstract Background Epidural analgesia is the mainstay of perioperative pain management in enhanced recovery programmes. This study compared short-term outcomes following epidural or intrathecal analgesia in patients undergoing elective laparoscopic colorectal surgery. Methods A single-centre observational study was carried out in 175 consecutive patients who had elective laparoscopic colorectal surgery for benign or malignant disease within an enhanced recovery programme. Seventy-six patients received epidural analgesia and 99 had a single injection of intrathecal analgesia to provide perioperative pain control. Results Patients who had intrathecal analgesia had a reduced median postoperative pain score compared with those receiving epidural analgesia (0 versus 3·5; P < 0·001), an earlier return to mobility (1 versus 4 days; P < 0·001) and a shorter hospital stay (4 versus 5 days; P < 0·001). Return to normal gut function and postoperative nausea and vomiting were similar in the two groups. Conclusion Intrathecal analgesia may have advantages over epidural analgesia in patients undergoing laparoscopic colorectal surgery.