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International Journal of Colorectal Disease

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01-01-2019 | Review

Thoracic epidural analgesia (TEA) versus patient-controlled analgesia (PCA) in laparoscopic colectomy: a systematic review and meta-analysis

Authors: Konstantinos Perivoliotis, Chamaidi Sarakatsianou, Stavroula Georgopoulou, George Tzovaras, Ioannis Baloyiannis

Published in: International Journal of Colorectal Disease | Issue 1/2019

Abstract

Purpose

A meta-analysis of RCTs was designed to provide an up-to-date comparison of thoracic epidural analgesia (TEA) and patient-controlled analgesia (PCA) in laparoscopic colectomy.

Methods

Our study was completed following the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature screening was performed in MEDLINE and Web of Science. Fixed effects (FE) or random effects (RE) models were estimated based on the Cochran Q test result.

Results

Totally, 8 studies were introduced in the present meta-analysis. Superiority of PCA in terms of length of hospital stay (LOS) (WMD 0.73, p = 0.004) and total complication rate (OR 1.57, p = 0.02) was found. TEA had a lower resting pain visual analogue scale (VAS) score at Day 1 (WMD − 2.23, p = 0.005) and Day 2 (WMD − 2.17, p = 0.01). TEA group had also a systematically lower walking VAS. Moreover, first bowel opened time (first defecation) (WMD − 0.88, p < 0.00001) was higher when PCA was applied.

Conclusions

TEA was related to a lower first bowel opened time, walking, and resting pain levels at the first postoperative days. However, the overall complication rate and LOS were higher in the epidural analgesia group. Thus, for a safe conclusion to be drawn, further randomized controlled trials (RCTs) of a higher methodological and quality level are required.

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Title: Thoracic epidural analgesia (TEA) versus patient-controlled analgesia (PCA) in laparoscopic colectomy: a systematic review and meta-analysis
Authors: Konstantinos Perivoliotis
Chamaidi Sarakatsianou
Stavroula Georgopoulou
George Tzovaras
Ioannis Baloyiannis
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 1/2019
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-3207-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Thoracic epidural analgesia (TEA) versus patient-controlled analgesia (PCA) in laparoscopic colectomy: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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