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Session: ePoster: Quality and Cost 1 (Sun8)

EP363 - The impact of spinal anesthesia in laparoscopic colorectal surgery on bowel function and pain relief - a meta-analysis of RCT

Sunday, May 11, 2025
9:33 AM – 9:38 AM PT
Location: Monitor 9, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Eleonora Bianchi

    Resident Doctor
    Kantonsspital Baden
    Spreitenbach, Aargau, Switzerland

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • MH

    Michael Heesen, n/a

    Head of department
    Spital Oberengadin
    Samaden, Graubunden, Switzerland

    Disclosure information not submitted.

  • AW

    Andrea Wirsching, n/a

    Oberärztin
    Departement Chirurgie
    Baden, Aargau, Switzerland

    Disclosure information not submitted.

  • AN

    Antonio Nocito, A.Nocito

    Prof. Dr. med.
    Kantonsspital Baden AG
    Baden, Aargau, Switzerland

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Eleonora Bianchi: This individual has no financial relationships with ineligible companies.
Antonio Nocito, A.Nocito: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Recently, the Enhanced Recovery After Surgery (ERAS) society recommended spinal anesthesia as a valuable adjunct to colorectal surgery with its primary advantages being enhanced pain control and reduced opioid use. Given that opioids can adversely affect bowel function, we hypothesized that spinal anesthesia may be associated with a reduction in postoperative ileus, an adverse effect that has not been sufficiently studied in this context. Therefore, this systematic review aims to examine the existing literature on the effect of spinal anesthesia on postoperative bowel function following colorectal surgery.

Methods/Interventions: Relevant articles were identified by searching Medline (Ovid), EMBASE (embase.com), CINAHL (EBSCOhost), Cochrane Library, Web of Science Core Collection and Scopus from the time of inception to October 2023. Inclusion criteria were studies comparing outcomes of colorectal surgery with and without spinal anesthesia. Primary outcomes of interest were time-to-oral diet, time-to-flatus, time-to-stool, morphine required within the first 24 hours postoperatively and pain scores 24 hours after surgery. The quality of the included articles was assessed using the Cochrane risk-of-bias tool for randomized trials.

Results/Outcomes: Five randomized controlled trials were identified from a total of 790 published articles, encompassing 338 patients who underwent laparoscopic colorectal surgery under general anesthesia, with or without spinal anesthesia. Spinal anesthesia was administered to 168 patients. No significant demographic differences were noted between the control and intervention groups. Spinal anesthesia was associated with improved postoperative pain control and a significant reduction in opioid consumption (MD: -0.749; CI -1.219 to -0.279, p-value: 0.002 and MD: -1.994; CI -2.315 to -1.673, p-value: < 0.001, respectively). However, no significant difference were observed between the groups in terms of postoperative bowel function: time to flatus MD: -0.054; 95% CI -0.268 to 0.160; p-value: 0.62; time to stool MD: -0.254; CI -0.526 to 0.018, p-value: 0.07; or time to resumption of a normal diet MD: -0.230; CI -0.490 to 0.031, p-value: 0.08.

Conclusion/Discussion: Spinal anesthesia in laparoscopic colorectal surgery significantly improves postoperative pain control and reduces opioid consumption. However, it does not appear to have a significant impact on postoperative bowel function.