Postoperative analgesia using fentanyl plus celecoxib versus epidural anesthesia after laparoscopic colon resection

Surg Today. 2017 Feb;47(2):174-181. doi: 10.1007/s00595-016-1356-y. Epub 2016 May 19.

Abstract

Purpose: Effective postoperative analgesia is essential to a patient's recovery after laparoscopic colon resection (LCR). We introduce a new analgesic protocol using fentanyl plus celecoxib following LCR.

Methods: The subjects of this retrospective comparative study were 137 patients who underwent LCR, 63 of whom were treated with 72 h of epidural anesthesia (group E), and 74 of whom were treated with 24 h of fentanyl intravenous injection followed by 7 days of oral celecoxib (group FC). We evaluated the safety and efficacy of this new protocol.

Results: The combination of fentanyl and celecoxib maintained a low postoperative pain score (<1.5, evaluated by the FACES Pain Scale) and reduced the need for rescue analgesic drugs for 7 days (groups E vs. FC: 5.39 ± 3.77 vs. 2.79 ± 2.92, p < 0.001). The postoperative hospital stay was almost equal for the two groups (E vs. FC: 11.1 ± 4.5 vs. 10.3 ± 4.8 days, p = 0.315). The operating room stay other than for surgery was significantly shorter for group FC (E vs. FC: 128.7 ± 30.5 vs. 107.2 ± 17.0 min, p < 0.001). Neither group experienced complications, apart from one group FC patient, who suffered transient nausea and vertigo.

Conclusions: The new analgesic protocol using fentanyl plus celecoxib is an effective and time-saving strategy for LCR.

Keywords: Anesthesia; Colon; Laparoscopy.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Analgesia / methods*
  • Anesthesia, Epidural*
  • Celecoxib / administration & dosage*
  • Colectomy*
  • Female
  • Fentanyl / administration & dosage*
  • Humans
  • Infusions, Intravenous
  • Laparoscopy*
  • Male
  • Middle Aged
  • Pain, Postoperative / therapy*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Celecoxib
  • Fentanyl