Our Summary

This research paper looks at the effects of using epidural analgesia (a type of pain relief medication administered in the back) on patients who have undergone a specific type of minimally invasive surgery known as laparoscopic sigmoidectomy. This surgery is used to remove part of the colon. The researchers stopped using epidural analgesia and instead used a different pain relief medication called lidocaine.

They looked at 160 patients who had this surgery between January 2014 and September 2016. Half of the patients had received epidural analgesia and half hadn’t. The researchers then compared various outcomes such as how long the patients stayed in the hospital, when they were able to move around and have a bowel movement after surgery, and any complications or need for additional surgeries.

They found that the patients who didn’t receive the epidural analgesia were able to leave the hospital sooner and start moving around quicker after surgery. The rate of complications was also lower in this group. However, the time of first bowel movement was quicker in the group that received the epidural. The amount of pain relief medication used wasn’t significantly different between the two groups, except for a medication called metamizole, which was used more in the group without epidural.

In conclusion, the researchers found that epidural analgesia did not offer any benefits for pain relief or outcomes after surgery. In fact, it led to a longer hospital stay, delayed movement after surgery, and a higher rate of complications.

FAQs

  1. What is a laparoscopic sigmoidectomy?
  2. What were the main findings of the research regarding the use of epidural analgesia in laparoscopic sigmoidectomy?
  3. Was there a difference in pain relief between the group that received epidural analgesia and the one that didn’t?

Doctor’s Tip

A doctor might advise a patient undergoing sigmoidectomy to discuss alternative pain relief options with their healthcare provider, as epidural analgesia may not provide additional benefits and could potentially lead to longer recovery times and increased risk of complications. It is important for patients to be informed and involved in the decision-making process regarding their post-operative pain management.

Suitable For

Patients who are typically recommended sigmoidectomy are those who have conditions such as diverticulitis, colorectal cancer, inflammatory bowel disease, or other conditions that affect the sigmoid colon. These patients may be experiencing symptoms such as abdominal pain, bloating, changes in bowel habits, or bleeding. Sigmoidectomy may be recommended when other treatments have not been effective in managing these symptoms or when there is a risk of complications such as perforation or obstruction of the colon.

Timeline

Before sigmoidectomy:

  • Patient undergoes preoperative testing and consultations with their healthcare team
  • Patient may need to follow a specific diet or bowel preparation regimen
  • Patient is admitted to the hospital on the day of surgery
  • Surgery is performed to remove part of the colon
  • Patient is monitored in the hospital post-surgery for pain management and recovery

After sigmoidectomy:

  • Patient may experience pain and discomfort post-surgery
  • Patient is monitored for complications such as infection or bleeding
  • Patient is encouraged to start moving around and eating as tolerated
  • Patient may need to stay in the hospital for a few days to a week
  • Patient is discharged from the hospital and given instructions for at-home care and follow-up appointments

Overall, the patient may experience a period of recovery and adjustment after sigmoidectomy, but with proper care and monitoring, most patients are able to return to their normal activities within a few weeks.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing a sigmoidectomy surgery?

  2. What is the typical recovery process like after a sigmoidectomy surgery?

  3. What are the different types of pain relief options available for post-operative pain management?

  4. How does epidural analgesia compare to other pain relief medications in terms of effectiveness and side effects?

  5. What are the potential complications or side effects associated with epidural analgesia?

  6. Are there any specific factors that would make me a good or poor candidate for epidural analgesia during a sigmoidectomy surgery?

  7. How will my pain be managed during and after the surgery if I choose not to use epidural analgesia?

  8. Are there any alternative pain relief options that I can consider instead of epidural analgesia?

  9. What are the expected outcomes and recovery timeline for patients who choose not to receive epidural analgesia during a sigmoidectomy surgery?

  10. Can you provide me with more information or resources to help me make an informed decision about whether or not to use epidural analgesia for my sigmoidectomy surgery?

Reference

Authors: Teixeira MB, van Loon YT, Wasowicz DK, Langenhoff BS, van Ieperen RP, Zimmerman DDE. Journal: J Gastrointest Surg. 2018 Oct;22(10):1779-1784. doi: 10.1007/s11605-018-3836-4. Epub 2018 Jun 25. PMID: 29943135