Mark E Chemali1, Guy D Eslick. 1. The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, Australia.
Abstract
INTRODUCTION: Enhanced Recovery After Surgery (ERAS) aims to minimize the length of a negative physiological response to surgical intervention. There are a number of aspects involved in ERAS protocols, one of which is postoperative pain relief. This meta-analysis investigates the current evidence for postoperative pain relief and its effect on patient pain and the length of stay after colorectal surgery. METHOD/ RESULTS: Medline, PubMed, and EMBASE databases were searched for relevant studies between January 1966 and February 2016. All randomized controlled trials comparing postoperative pain management strategies in an ERAS setting with the length of stay as an outcome measure were selected. In addition to the length of stay, other outcomes analyzed were pain scores at 24 hours postoperatively, nausea, vomiting, and the time to the first bowel motion. RESULTS: There was a decrease in vomiting in the ERAS group compared with the control groups (relative risk=0.82; 95% confidence interval, 0.52-1.27). Mean differences in the length of stay (P=0.879), pain visual analogue scales (P=0.120), the time to the first bowel motion in hours (P=0.371), and nausea (P=0.083) were not statistically significant. CONCLUSIONS: In an ERAS setting with regard to a colorectal patient population, the choice of modality for postoperative pain relief does not impact the length of hospital stay, pain, the time to the first bowel motion, or nausea.
INTRODUCTION: Enhanced Recovery After Surgery (ERAS) aims to minimize the length of a negative physiological response to surgical intervention. There are a number of aspects involved in ERAS protocols, one of which is postoperative pain relief. This meta-analysis investigates the current evidence for postoperative pain relief and its effect on patientpain and the length of stay after colorectal surgery. METHOD/ RESULTS: Medline, PubMed, and EMBASE databases were searched for relevant studies between January 1966 and February 2016. All randomized controlled trials comparing postoperative pain management strategies in an ERAS setting with the length of stay as an outcome measure were selected. In addition to the length of stay, other outcomes analyzed were pain scores at 24 hours postoperatively, nausea, vomiting, and the time to the first bowel motion. RESULTS: There was a decrease in vomiting in the ERAS group compared with the control groups (relative risk=0.82; 95% confidence interval, 0.52-1.27). Mean differences in the length of stay (P=0.879), pain visual analogue scales (P=0.120), the time to the first bowel motion in hours (P=0.371), and nausea (P=0.083) were not statistically significant. CONCLUSIONS: In an ERAS setting with regard to a colorectalpatient population, the choice of modality for postoperative pain relief does not impact the length of hospital stay, pain, the time to the first bowel motion, or nausea.
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