Postoperative Pain
Conditions
Keywords
postoperative analgesia, neuropathic pain, laparoscopic colorectal surgery
Brief summary
Comparison of different postoperative analgesia after laparoscopic colorectal surgery
Detailed description
Postoperative pain treatment should be multimodal and opioid sparing. Thoracic epidural analgesia could relieve pain after laparoscopic surgery. Although ERAS guidelines suggest to use less invasive pain relieve technique, opioids are widely used perioperatively, despite of their side effects. Non-opioids and 5% lidocaine patches, used topicaly, could effectively reduce opioid consumption and their side effects. Namely, efficient perioperative pain treatment is important to prevent late neuropathic pain, also after laparoscopic lower abdominal surgery. Its incidence is usually low compared to open surgery. The aim of present study was to evaluate, if opioid consumption in laparoscopic colorectal surgery could be reduced with lidocaine patch at the wound site or with infusion of metamizole and tramadol and if the results meets epidural analgesia. We also compared the incidence of postoperative neuropathic pain among groups. Prospective, randomised trial with 4 parallel groups was conducted at the University medical centre (UMC) Ljubljana. ASA (American Society of Anaesthesiologists) Class 2-3 high risk surgical patients from the Clinical department of abdominal surgery were included in the study. Adult patients that underwent laparoscopic colorectal surgery were included.
Interventions
Comparison of 4 possible analgesic protocols
Sponsors
Study design
Masking description
Randomised by random number generator after meeting the inclusion criteria.
Intervention model description
4 parallel groups with different method of analgesia after laparoscopic colorectal resection.
Eligibility
Inclusion criteria
* scheduled elective laparoscopic colorectal surgery
Exclusion criteria
* critical preoperative state, pregnant women, laparotomy and palliative procedures.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of neuropathic pain | first 3 months after surgery | Detecting of neuropathic pain using DN4 and PainDetect Questionnaire. These are clinically validated tools for detecting the presence of neuropathic pain and evaluating the severity. |
| Total opioid consumption | 0-48 hours after surgical procedure | Measurement of piritramide consumprion |