Year 2017 / Volume 24 / Number 5

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Epidural analgesia vs. surgical wound analgesia to control acute post-operative pain in open colon surgery

Rev Soc Esp Dolor 2017; 24(5): 234-240 / DOI: 10.20986/resed.2017.3559/2016

O. Figueiredo González, L. Gómez Viana, C. Zepeda Blanco, M. L. Casas García y F. Domínguez Hervella Servicio de Anestesiología, Reanimación y Terapéutica del Dolor. Complexo Hospitalario Universitario de Ourense. España


ABSTRACT

Objective: To establish if the incisional catheters provide the same analgesia for the control of DAP (postoperative acute pain) with fewer side effects than epidural analgesia in postoperative patients of open colon surgery.

Material and methods: This is a retrospective cohort study of 33 patients in whom epidural analgesia was used between November 2013 and November 2014, and prospective where
a catheter placed in the surgical wound was used between November 2014 and November 2015 in 25 patients. The variables studied were: demographic (sex, date of birth, BMI, weight and height, drug allergies, personal history and anesthetic risk according to the ASA scale), duration of the intervention from the time of the surgical incision to the wound closure, surgical technique (right left or sigma colon) and number of catheters used.

Results: We included 58 patients. 56.9 % were given epidural analgesia. Patients in the Incisional group had a significant increase in pain between 150 minutes and 24 hours (1.20 vs. 3.50 p < 0.001). In the Epidural group, this increase did not become significant (1.18 vs. 2.06, p = 0.069). There was a significant decrease in pain between 24 and 48 hours in both the Incisional group (3.50 vs. 2.67, p = 0.004) and in the Epidural group (2.06 vs. 1.58, p = 0.021). The presence of side effects at 24 hours was observed in 20 % of patients in the Incisional group and 27.3 % in the Epidural group (p = 0.522).

Conclusions: The pain perceived by patients in the Epidural group was lower than that perceived by patients in the Incisional group at both 24 and 48 hours. In both groups there was an increase of pain at 24 hours of the intervention, however this increase was lower in the Epidural group. Regarding the presence of side effects, both groups had a similar behavior.

Key words: Analgesia epidural, analgesia incisional, pain acute postoperative, surgery of colon open.


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O. Figueiredo González, L. Gómez Viana, C. Zepeda Blanco, M. L. Casas García y F. Domínguez Hervella Servicio de Anestesiología, Reanimación y Terapéutica del Dolor. Complexo Hospitalario Universitario de Ourense. España. Epidural analgesia vs. surgical wound analgesia to control acute post-operative pain in open colon surgery. Rev Soc Esp Dolor 2017; 24(5): 234-240 / DOI: 1020986/resed20173559/2016


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