Perioperative Analgesic Strategies in Elective Laparoscopic Colorectal

• Research type

  Research Study

• Full title

  A Prospective, Multicentre Observational Study of Perioperative Analgesic Strategies in Elective Laparoscopic Colorectal Surgery - The LapCoGesic Study

• IRAS ID

  172683

• Contact name

  Deena Harji

• Sponsor organisation

  County Durham and Darlington NHS Foundation Trust

• Duration of Study in the UK

  0 years, 2 months, 1 days

• Research summary

  The benefits of laparoscopic colorectal surgery have been established over open colorectal surgery. The reduced amount of pain conferred by laparoscopic surgery is associated with earlier mobilisation, reduced length of hospital stay and quicker recovery. Essential to this expedient recovery is appropriate and effective analgesia in the preoperative period. In open colorectal surgery the use of a thoracic epidural is deemed the gold standard analgesic strategy. However, the use of thoracic epidural analgesia in the laparoscopic setting does not produce the same results, with reports of reports of longer length of stay and delayed return of gastrointestinal function. This has led to a number of alternative analgesic strategies to be employed in laparoscopic colorectal surgery, including the use of spinal anaesthesia, patient controlled analgesia, subcutaneous and/or intraperitoneal local anaesthetics, local anaesthetic wound infiltration catheters and transverse abdominal plane (TAP) blocks. There have been a number of prospective cohort studies and randomised controlled trials comparing different analgesic modalities with encouraging results, however, there remains a lack of consensus on the optimal analgesic strategy in this cohort of patients, thus leading to colorectal units employing analgesic regimes based on individual expertise and experience. The LapCoGesic Study aims to explore the variation in current analgesic regimes in elective laparoscopic colorectal practice and determine whether any relationships exist between analgesic regimes and clinical outcomes.

• REC name

  North East - York Research Ethics Committee

• REC reference

  15/NE/0110

• Date of REC Opinion

  17 Mar 2015

• REC opinion

  Favourable Opinion