PROLONGED EPIDURAL ANALGESIA AFTER COLORECTAL SURGERY IN ELDERLY PATIENTS



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Abstract

Objective: to compare the effectiveness of prolonged epidural analgesia by continuous infusion or bolus administration on demand, as well as the timing and volume of early mobilization with two methods of postoperative analgesia. Material and methods: prospective randomized study enrolled 161 patients with colorectal cancer aged from 60 to 89 years, operated by means of laparotomy and laparoscopy. In the main group (n=80), postoperative prolonged epidural analgesia was carried out using individual pumps with an initial rate of 0.2% ropivacaine solution of 4-6 ml/h. In the comparison group, epidural analgesia was provided by bolus administration of 4-6 ml of 0.2% ropivacaine solution on demand. Results: In the main group with open surgical interventions, in contrast to the comparison group, prolonged epidural analgesia provided a decrease in the intensity of pain on the second (2.7 ± 1.8 and 4.1 ± 1.4 score, p < 0.001), third (2.6 ± 1.6 and 3.9 ± 1.1 score, p < 0.001), fourth day (2.3 ± 1.7 and 3.5 ± 1.2 score, p < 0.001). Prolonged epidural analgesia in the main group allowed more patients to be activated on the second (64.2% (52 of 81), p < 0.001), third (97.5% (79 of 81), p < 0.001) and fourth (100%, p < 0.002) days. The average time of activity in the main group was three times higher on the third day and twice - on the fourth day (p < 0.001). Conclusion: Postoperative prolonged epidural analgesia is highly effective in elderly patients during their treatment with enhanced recovery methods.

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About the authors

Alexander V. Savushkin

State Scientific Centre of Coloproctology

Email: a.v.savushkin@bk.ru
State Scientific Centre of Coloproctology, Moscow, 123423, Russian Federation Moscow, 123423, Russian Federation

E. A Khachaturova

State Scientific Centre of Coloproctology

Moscow, 123423, Russian Federation

E. V Balykova

State Scientific Centre of Coloproctology

Moscow, 123423, Russian Federation

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