JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)

• Original article (Evidence-based Medicine) • Previous Articles     Next Articles

Application of two kinds of analgesia after colorectal cancer surgery: a meta-analy

CHEN Zhi-ling, LUO Chen, ZHAO Kang-jia, SHEN Ling, HU San-lian   

  1. ##Shanghai 200025, China; 3.Department of General Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Received:2021-05-06 Published:2021-09-23
  • Contact: SHEN Ling, E-mail: shenling@xinhuamed.com.cn. HU San-lian, E-mail: liuliu9027@163.com. #Co-corresponding authors.
  • Supported by:
    Shanghai Municipal Education Commission of Nursing Gaoyuan Discipline Construction Project—Multidisciplinary Innovation Fund Project(Hlgy1808dxk).

Abstract: Objective·To explore the safety and the analgesia effect of intravenous analgesia and epidural analgesia in the patients with colorectal cancer after surgery. Methods·The literature search was conducted in the Chinese databases, i.e. CNKI, WanFang, CBM, and VIP, and the abroad databases, i.e.PubMed, Web of Science, Embase, Cochrane Library and Joanna Briggs Institute(JBI) for randomized controlled trials(RCTs), controlled clinical trials(CCTs) and case-control studies(CCSs) about the effects of intravenous analgesia and epidural analgesia on the patients with colorectal cancer after surgery from January 2010 to November 2020, in the languages of Chinese and English. Three researchers independently conducted literature screening and quality evaluation in strict accordance with the standards, and extracted effective data such as study type, sample size, age, intraoperative anesthesia mode, postoperative analgesic drugs and outcome indicators, which were input into RevMan 5.4 software for meta-analysis. Results·A total of 20 literatures, including 13 RCTs, 6 CCTs and 1 CCS, involving 1 615 patients. There were 813 cases in the epidural analgesia group and 802 cases in the intravenous analgesia group. Compared with intravenous analgesia, postoperative epidural analgesia had significant lower visual analogue scores(VAS)of pain at 6 h, 24 h, and 48 h, shorter hospital stay and time to first feeding after operation, and lower incidences of ileus and nausea and vomiting(all P<0.05). Conclusion·Compared with intravenous analgesia, postoperative epidural analgesia for the colorectal neoplasms patients is better in the analgesic effect 6 h, 24 h, and 48 h after surgery, effectively shortens the hospital stay and time to first feeding after operation, and reduces the incidences of ileus and nausea and vomiting.

Key words: colorectal cancer, epidural analgesia, intravenous analgesia, analgesic effect, meta-analysis

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