Laparoscopic colorectal surgery and postoperative opioid requirements

Excerpt

We thank Dr. Ousmane and colleagues [1] for presenting the results of their study into analgesic requirements following surgery for Crohn’s disease by laparoscopic versus open approaches. Their control groups suggested no difference in opioid use following either operative approach, while Crohn’s sufferers appeared to derive clear benefits from laparoscopy. Although the authors are correct in pointing out that our recent meta-analysis [2] did not include a comparison between laparoscopy for Crohn’s resections and surgery for non-inflammatory conditions, that was not the stated aim of our study. While our analysis suggested a trend toward a reduction in the mean duration of opioid analgesia requirements (1.66 days less in laparoscopy patients), we highlighted in the text of our paper that this effect did not achieve statistical significance (p = 0.11); this despite the finding that three of the five individual studies in which the outcome could be assessed suggested significant reductions in analgesia for the laparoscopy group [3, 4, 5]. There was also a highly significant degree of heterogeneity between studies associated with this outcome. …