Spinal analgesia for laparoscopic colonic resection using an enhanced recovery after surgery programme: better analgesia, but no benefits on postoperative recovery: a randomized controlled trial
This study was undertaken to determine the impact of an intrathecal mixture of bupivacaine and morphine, when compared with systemic morphine, on the quality of postoperative analgesia and other outcomes in the context of the enhanced recovery after surgery (ERAS) programme for laparoscopic colonic...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2012-05, Vol.108 (5), p.850-856 |
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| creator | Wongyingsinn, M. Baldini, G. Stein, B. Charlebois, P. Liberman, S. Carli, F. |
| description | This study was undertaken to determine the impact of an intrathecal mixture of bupivacaine and morphine, when compared with systemic morphine, on the quality of postoperative analgesia and other outcomes in the context of the enhanced recovery after surgery (ERAS) programme for laparoscopic colonic resection.
Fifty patients undergoing general anaesthesia were randomly allocated to receive either a spinal mixture of bupivacaine and morphine followed by oral oxycodone (spinal group) or patient-controlled analgesia (PCA group). The primary outcome was consumption of opioids during the first three postoperative days. Secondary outcomes were pain scores, return of bowel function and dietary intake, readiness to hospital discharge, and length of hospital stay.
Postoperative opioid consumption in the spinal group was significantly less over the first three postoperative days (P |
| doi_str_mv | 10.1093/bja/aes028 |
| format | Article |
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Fifty patients undergoing general anaesthesia were randomly allocated to receive either a spinal mixture of bupivacaine and morphine followed by oral oxycodone (spinal group) or patient-controlled analgesia (PCA group). The primary outcome was consumption of opioids during the first three postoperative days. Secondary outcomes were pain scores, return of bowel function and dietary intake, readiness to hospital discharge, and length of hospital stay.
Postoperative opioid consumption in the spinal group was significantly less over the first three postoperative days (P<0.001). The quality of analgesia at rest in the first 24 h was better in the spinal group (P<0.005). Excessive sedation and respiratory depression were reported in two elderly patients with spinal analgesia. There were no differences between the two groups in other outcomes (return of bowel function and dietary intake, readiness to hospital discharge, and length of hospital stay).
When ERAS programme is used for laparoscopic colonic resection, an intrathecal mixture of bupivacaine and morphine was associated with less postoperative opioid consumption, but has no other advantages over systemic opioids.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aes028</identifier><identifier>PMID: 22408272</identifier><identifier>CODEN: BJANAD</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject><![CDATA[Adult ; Aged ; Aged, 80 and over ; anaesthetic techniques, subarachnoid ; analgesia, patient-controlled ; Analgesia, Patient-Controlled - methods ; analgesia, postoperative ; Analgesics, Opioid - administration & dosage ; Anesthesia ; Anesthesia Recovery Period ; Anesthesia, General ; Anesthesia, Spinal - methods ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthetics, Local - administration & dosage ; Biological and medical sciences ; Bupivacaine - administration & dosage ; Colectomy - adverse effects ; Colectomy - methods ; Drug Administration Schedule ; Drug Combinations ; Female ; Humans ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Male ; Medical sciences ; Middle Aged ; Morphine - administration & dosage ; Pain Measurement - methods ; Pain, Postoperative - prevention & control ; Postoperative Care - methods ; Postoperative Complications]]></subject><ispartof>British journal of anaesthesia : BJA, 2012-05, Vol.108 (5), p.850-856</ispartof><rights>2012 The Author(s)</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-ab1f41f0e69d8ce33bbf70f5630a093625bb8871aafaaa52cde162ab266d18403</citedby><cites>FETCH-LOGICAL-c398t-ab1f41f0e69d8ce33bbf70f5630a093625bb8871aafaaa52cde162ab266d18403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25820836$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22408272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wongyingsinn, M.</creatorcontrib><creatorcontrib>Baldini, G.</creatorcontrib><creatorcontrib>Stein, B.</creatorcontrib><creatorcontrib>Charlebois, P.</creatorcontrib><creatorcontrib>Liberman, S.</creatorcontrib><creatorcontrib>Carli, F.</creatorcontrib><title>Spinal analgesia for laparoscopic colonic resection using an enhanced recovery after surgery programme: better analgesia, but no benefits on postoperative recovery: a randomized controlled trial</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><description>This study was undertaken to determine the impact of an intrathecal mixture of bupivacaine and morphine, when compared with systemic morphine, on the quality of postoperative analgesia and other outcomes in the context of the enhanced recovery after surgery (ERAS) programme for laparoscopic colonic resection.
Fifty patients undergoing general anaesthesia were randomly allocated to receive either a spinal mixture of bupivacaine and morphine followed by oral oxycodone (spinal group) or patient-controlled analgesia (PCA group). The primary outcome was consumption of opioids during the first three postoperative days. Secondary outcomes were pain scores, return of bowel function and dietary intake, readiness to hospital discharge, and length of hospital stay.
Postoperative opioid consumption in the spinal group was significantly less over the first three postoperative days (P<0.001). The quality of analgesia at rest in the first 24 h was better in the spinal group (P<0.005). Excessive sedation and respiratory depression were reported in two elderly patients with spinal analgesia. There were no differences between the two groups in other outcomes (return of bowel function and dietary intake, readiness to hospital discharge, and length of hospital stay).
When ERAS programme is used for laparoscopic colonic resection, an intrathecal mixture of bupivacaine and morphine was associated with less postoperative opioid consumption, but has no other advantages over systemic opioids.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>anaesthetic techniques, subarachnoid</subject><subject>analgesia, patient-controlled</subject><subject>Analgesia, Patient-Controlled - methods</subject><subject>analgesia, postoperative</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Anesthesia</subject><subject>Anesthesia Recovery Period</subject><subject>Anesthesia, General</subject><subject>Anesthesia, Spinal - methods</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Bupivacaine - administration & dosage</subject><subject>Colectomy - adverse effects</subject><subject>Colectomy - methods</subject><subject>Drug Administration Schedule</subject><subject>Drug Combinations</subject><subject>Female</subject><subject>Humans</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Morphine - administration & dosage</subject><subject>Pain Measurement - methods</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Postoperative Care - methods</subject><subject>Postoperative Complications</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkU2LFDEQhhtR3HH14g-QXAQRx03SX-m9yeIXLHhQz00lXRmzpJM2SQ-sP89fZg0zjhcvqRT15C3yvlX1XPC3gg_1lb6DK8DMpXpQbUTTi23X9-JhteGc91s-CHlRPcn5jnPRy6F9XF1I2XAle7mpfn9dXADPgI4dZgfMxsQ8LJBiNnFxhpnoY6CaMKMpLga2Zhd29IRh-AHB4EQzE_eY7hnYgonlNe0O3ZLiLsE84zXTWA6T8543TK-FhUiDgNaVzEh4ibnEBRMUt8ez6DUDliBMcXa_aJeJoaToPV1LcuCfVo8s-IzPTvWy-v7h_bebT9vbLx8_37y73Zp6UGULWthGWI7dMCmDda217bltu5oDudjJVmulegFgAaCVZkLRSdCy6yahGl5fVq-OuvSrnyvmMs4uG_QeAsY1j4LsJqxVNaGvj6ghF3NCOy7JzZDuCRoPmY2U2XjMjOAXJ91Vzzid0b8hEfDyBEA24C15YVz-x7VKclV3xDVHDsmFvcM0ZuPwkI8jK8s4Rfe__X8Az-q4cQ</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Wongyingsinn, M.</creator><creator>Baldini, G.</creator><creator>Stein, B.</creator><creator>Charlebois, P.</creator><creator>Liberman, S.</creator><creator>Carli, F.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>Spinal analgesia for laparoscopic colonic resection using an enhanced recovery after surgery programme: better analgesia, but no benefits on postoperative recovery: a randomized controlled trial</title><author>Wongyingsinn, M. ; Baldini, G. ; Stein, B. ; Charlebois, P. ; Liberman, S. ; Carli, F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-ab1f41f0e69d8ce33bbf70f5630a093625bb8871aafaaa52cde162ab266d18403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>anaesthetic techniques, subarachnoid</topic><topic>analgesia, patient-controlled</topic><topic>Analgesia, Patient-Controlled - methods</topic><topic>analgesia, postoperative</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Anesthesia</topic><topic>Anesthesia Recovery Period</topic><topic>Anesthesia, General</topic><topic>Anesthesia, Spinal - methods</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Bupivacaine - administration & dosage</topic><topic>Colectomy - adverse effects</topic><topic>Colectomy - methods</topic><topic>Drug Administration Schedule</topic><topic>Drug Combinations</topic><topic>Female</topic><topic>Humans</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Morphine - administration & dosage</topic><topic>Pain Measurement - methods</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Postoperative Care - methods</topic><topic>Postoperative Complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wongyingsinn, M.</creatorcontrib><creatorcontrib>Baldini, G.</creatorcontrib><creatorcontrib>Stein, B.</creatorcontrib><creatorcontrib>Charlebois, P.</creatorcontrib><creatorcontrib>Liberman, S.</creatorcontrib><creatorcontrib>Carli, F.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wongyingsinn, M.</au><au>Baldini, G.</au><au>Stein, B.</au><au>Charlebois, P.</au><au>Liberman, S.</au><au>Carli, F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Spinal analgesia for laparoscopic colonic resection using an enhanced recovery after surgery programme: better analgesia, but no benefits on postoperative recovery: a randomized controlled trial</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><addtitle>Br J Anaesth</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>108</volume><issue>5</issue><spage>850</spage><epage>856</epage><pages>850-856</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><coden>BJANAD</coden><abstract>This study was undertaken to determine the impact of an intrathecal mixture of bupivacaine and morphine, when compared with systemic morphine, on the quality of postoperative analgesia and other outcomes in the context of the enhanced recovery after surgery (ERAS) programme for laparoscopic colonic resection.
Fifty patients undergoing general anaesthesia were randomly allocated to receive either a spinal mixture of bupivacaine and morphine followed by oral oxycodone (spinal group) or patient-controlled analgesia (PCA group). The primary outcome was consumption of opioids during the first three postoperative days. Secondary outcomes were pain scores, return of bowel function and dietary intake, readiness to hospital discharge, and length of hospital stay.
Postoperative opioid consumption in the spinal group was significantly less over the first three postoperative days (P<0.001). The quality of analgesia at rest in the first 24 h was better in the spinal group (P<0.005). Excessive sedation and respiratory depression were reported in two elderly patients with spinal analgesia. There were no differences between the two groups in other outcomes (return of bowel function and dietary intake, readiness to hospital discharge, and length of hospital stay).
When ERAS programme is used for laparoscopic colonic resection, an intrathecal mixture of bupivacaine and morphine was associated with less postoperative opioid consumption, but has no other advantages over systemic opioids.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>22408272</pmid><doi>10.1093/bja/aes028</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over anaesthetic techniques, subarachnoid analgesia, patient-controlled Analgesia, Patient-Controlled - methods analgesia, postoperative Analgesics, Opioid - administration & dosage Anesthesia Anesthesia Recovery Period Anesthesia, General Anesthesia, Spinal - methods Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthetics, Local - administration & dosage Biological and medical sciences Bupivacaine - administration & dosage Colectomy - adverse effects Colectomy - methods Drug Administration Schedule Drug Combinations Female Humans Laparoscopy - adverse effects Laparoscopy - methods Length of Stay - statistics & numerical data Male Medical sciences Middle Aged Morphine - administration & dosage Pain Measurement - methods Pain, Postoperative - prevention & control Postoperative Care - methods Postoperative Complications |
| title | Spinal analgesia for laparoscopic colonic resection using an enhanced recovery after surgery programme: better analgesia, but no benefits on postoperative recovery: a randomized controlled trial |
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