Vs. analgesia in surgical wound epidural analgesia for post surgical operative pain control in open colon surgery

Abstract

Abstract Objective: establish if them catheters incisional provide the same analgesia for the control of the DAP with less number of effects side that the analgesia epidural in patients undergone of surgery of colon open. Material and methods: is is from a study of cohorts retrospective of 33 patients in which is has used analgesia epidural between November of 2013 and November of 2014 and prospective where is used a catheter placed in the wound surgical between November of 2014 and November of 2015 in 25 patients. Results: when calculating the differences between the EVA at discharge and at 24 h got the Incisional group patients suffered significantly higher than those in the Epidural group pain increased. Between the EVA to the high and to the 48 h not is observed differences statistically significant between the two groups, although the increase of EVA was greater in the Group Incisional. Not is observed differences significant in the presence of effects side to the 24 h and 48 h between the two groups. Conclusions: taking into account the limitation of the study by the small number of patients (impossibility of having more incisional catheters) and the subjectivity of the EVA, we conclude that epidural analgesia is still more effective for the control of the DAP after open colon surgery there is no statistically significant difference in the occurrence of side effects throughout the 48 hours between the two groups though incisional analgesia can be considered a good alternative especially in certain cases. 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.