Early oral nutrition after elective colorectal surgery: influence of balanced analgesia and enforced mobilization

Abstract

Early postoperative nutrition reduces morbidity. We investigated whether the introduction of a new postoperative analgesic and ambulation regimen with enforced mobilization from postoperative day 1 would influence postoperative nutrition intake. Nutrition intake was recorded daily by a record method and compared with the intake in a control group that received the same nutrition regimen but a traditional analgesic and ambulation regimen. The mean intakes of energy during postoperative days 1 to 5 were 73 kJ x kg(-1) x d(-1) in the intervention group and 52 kJ x kg(-1) x d(-1) in the control group (P = 0.04). Protein intakes in the same period were 0.95 g x kg(-1) x d(-1) in the intervention group and 0.57 g x kg(-1) x d(-1) in the control group (P < 0.01). We found that a regimen based on epidural analgesia with local anesthetics, enforced mobilization, and the use of immediate postoperative oral nutrition leads to substantial nutrition intake after colonic surgery during the first postoperative days.