Effect of epidural analgesia on postoperative opioid requirements following elective laparotomies performed at Vancouver General Hospital - 20/05/21
Abstract |
Background |
Enhanced recovery pathways aim to reduce postoperative opioid use and opioid-related complications. These pathways often include epidural analgesia (EA). This study examines postoperative opioid use after elective laparotomy with and without EA.
Methods |
Retrospective chart review of elective laparotomies performed by General Surgery at a tertiary academic center during 2017 was completed. Primary outcome was postoperative opioid usage. Secondary outcomes were time to mobilization, duration of urinary catheterization and postoperative ileus.
Results |
Among 236 patients, 213 (90%) received EA. There was no significant difference in mean total oral morphine equivalent (OME) usage between EA and non-EA groups. Mean OME use on postoperative day three was higher in the EA group (38.0 vs 22.4 mg, p = 0.02). On multivariate analysis, preoperative opioid use was associated with increased postoperative OME consumption (regression coefficient 147.5, p < 0.001).
Conclusions |
In this cohort, epidural analgesia did not reduce postoperative opioid consumption.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Current enhanced recovery pathways emphasize reducing postoperative opioid use. |
• | Epidural analgesia was not associated with reduced postoperative opioid use. |
• | History of preoperative opioid use is associated with postoperative opioid use. |
Keywords : Postoperative opioid use, Epidural analgesia, Enhanced recovery after surgery, Elective laparotomy
Plan
Vol 221 - N° 6
P. 1228-1232 - juin 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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