Spinal Analgesia for Colonic Resection Using an Enhanced Recovery After Surgery (ERAS) Program

McGill University Health Centre/Research Institute of the McGill University Health Centre40 enrolled

Overview

This is a blinded randomized controlled trial in patients undergoing laparoscopic colon surgery. The aim of this study is to assess whether spinal analgesia with a mixture of bupivacaine and morphine provides better pain relief than systemic morphine in a group of patients undergoing colonic resection and using the Enhanced Recovery After Surgery (ERAS) program. Twenty patients will receive spinal analgesia and twenty patients will receive only Patient Control Analgesia (PCA).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Colon Cancer Inflammatory Bowel Diseases Diverticulitis

Interventions

Spinal analgesiaDRUG

isobaric bupivacaine 0.5% 10 mg together with preservative-free morphine was injected. The dose of morphine was based on patient's age, with 200 μg in patients aged ≤ 75 years and 150 μg in patients aged \> 75 years.

Patient Control Analgesia (PCA) MorphineDRUG

PCA Morphine is set to the patient for 48 hours postoperative. 2 mg. of morphine is given to a patient as much as patient requires, maximum at every 7 minutes.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients scheduled to undergo laparoscopic colonic resection Exclusion Criteria: * patients who have trouble to understand, read or communicate either in French or in English * dementia * patients suffering from severe physical disability (arthritis, neuromuscular dysfunction, stroke, paraplegia) or inability to walk or conduct daily activity * patients suffering from severe cardiac or respiratory disease (status ASA IV) * patients suffering from metastatic carcinoma * patients who have a history of chemoradiation within the six months preceding surgery * morbid obesity * contraindication to spinal analgesia

Outcomes

Primary Outcomes

postoperative pain

Time frame: daily during hospitalization up to 3 days after the operation

Secondary Outcomes

opioid consumption