Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Dec 29;39(1):12.
doi: 10.1007/s00384-023-04580-w.

A prospective randomized study of multimodal analgesia combined with single injection transversus abdominis plane block versus epidural analgesia against postoperative pain after laparoscopic colon cancer surgery

Hiroshi Kitagawa  1 , Tatsuya Manabe  2 , Yasutaka Yamada  3 , Hirofumi Sato  1 , Shin Takesue  1 , Masatsugu Hiraki  1 , Atsushi Kawaguchi  4 , Yoshiro Sakaguchi  3 , Hirokazu Noshiro  1
Affiliations
Randomized Controlled Trial

A prospective randomized study of multimodal analgesia combined with single injection transversus abdominis plane block versus epidural analgesia against postoperative pain after laparoscopic colon cancer surgery

Hiroshi Kitagawa et al. Int J Colorectal Dis. .

Abstract

Purpose: Transversus abdominis plane (TAP) block is a safe, effective, and promising analgesic procedure, but TAP block only cannot overcome postoperative pain. We conducted a prospective randomized study to evaluate postoperative pain control using multimodal analgesia (MA) combined with a single injection TAP block compared with epidural analgesia (EA) after laparoscopic colon cancer surgery.

Methods: Sixty-seven patients scheduled for elective laparoscopic colon cancer surgery were enrolled in this study and randomized into EA and MA groups. The primary endpoint was the frequency of additional analgesic use until postoperative day (POD) 2. The VAS score, blood pressure, time to bowel movement, time to mobilization, postoperative complications, and length of hospital stay were also compared between the two groups.

Results: Sixty-four patients (EA group, n = 33; MA group, n = 31) were analyzed. The patient characteristics did not differ markedly between the two groups. The frequency of additional analgesic use was significantly lower in the MA group than in the EA group (P < 0.001), whereas the VAS score did not differ markedly between the two groups. The postoperative blood pressure on the day of surgery was significantly lower in the MA group than in the EA group (P = 0.016), whereas urinary retention was significantly higher in the EA group than in the MA group (P < 0.001).

Conclusion: MA combined with a single injection TAP block after laparoscopic colon cancer surgery may be comparable to EA in terms of analgesia and superior to EA in terms of urinary retention.

Keywords: Epidural analgesia; Laparoscopic colon surgery; Multimodal analgesia; Single injection transversus abdominis plane block.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

References

    1. Kehlet H, Holte K (2001) Effect of postoperative analgesia on surgical outcome. Br J Anaesth 87:62–72. https://doi.org/10.1093/bja/87.1.62 - DOI - PubMed
    1. Hou BJ, Du Y, Gu SX, Fan J, Wang R, Deng H, Guo DX, Wang L, Wang YY (2019) General anesthesia combined with epidural anesthesia maintaining appropriate anesthesia depth may protect excessive production of inflammatory cytokines and stress hormones in colon cancer patients during and after surgery. Medicine (Baltimore) 98(30):1–5. https://doi.org/10.1097/MD.0000000000016610
    1. Carli F, Kehlet H, Baldini G, Steel A, McRae K, Slinger P, Hemmerling T, Salinas F, Neal JM (2011) Evidence basis for regional anesthesia in multidisciplinary fast-track surgical care pathways. Reg Anesth Pain Med 36:63–72. https://doi.org/10.1097/AAP.0b013e31820307f7 - DOI - PubMed
    1. Carli F, Halliday D (1997) Continuous epidural blockade arrests the postoperative decrease in muscle protein fractional synthetic rate in surgical patients. Anesthesiology 86(5):1033–1040. https://doi.org/10.1097/00000542-199705000-00005
    1. Guay J, Nishimori M, Kopp SL (2016) Epidural local anesthetics versus opioid-based analgesic regimens for postoperative gastrointestinal paralysis, vomiting, and pain after abdominal surgery: a Cochrane review. Anesth Analg 123:1591–1602. https://doi.org/10.1213/ANE.0000000000001628 - DOI - PubMed

Publication types

LinkOut - more resources