A Meta-Analysis: Postoperative Pain Management in Colorectal Surgical Patients and the Effects on Length of Stay in an Enhanced Recovery After Surgery (ERAS) Setting.

A Meta-Analysis: Postoperative Pain Management in Colorectal Surgical Patients and the Effects on Length of Stay in an Enhanced Recovery After Surgery (ERAS) Setting.

Chemali ME1, Eslick GD. Clin J Pain. 2017 Jan;33(1):87-92.

What is already known:

Well managed pain relief aims to minimise side-effects and enable the main goals of ERAS to be achieved, including early mobilisation and early nutrition.

What this paper adds:

Optimal analgesia is an essential part of a successful ERAS programme, so the authors should be commended for conducting this important review. They included 21 separate RCT’s of several different types of analgesia comparisons, eg Lidocaine vs epidural, epidural vs PCA etc. This meta-analysis included colorectal RCT’s with pain as a major part of the study and length of stay as the main outcome. Overall they found no difference in their main outcome which was length of stay. However there are a number of flaws in this review. The studies they used were a mix of open and laparoscopic surgery, and not clear if all studies used a comprehensive ERAS programme as part of the standard care, in which case its difficult to draw accurate conclusions.

Chris Jones, Guildford.