The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
Is Urinary Drainage Necessary During Continuous Epidural Analgesia After Colonic Resection?
Background and Objectives Postoperative urinary retention may occur in between 10 % and 60 % of patients after major surgery . Continuous lumbar epidural analgesia , in contrast to thoracic epidural analgesia , may inhibit urinary bladder function . Postoperative urinary drainage has been common in patients with continuous epidural analgesia , despite the lack of scientific evidence for its indication after thoracic epidural analgesia . This study describes 100 patients who underwent elective colonic resection with 48 hours of continuous thoracic epidural analgesia and only 24 hours of urinary drainage .  Methods This is a prospect i ve , uncontrolled study with well-defined general anesthesia , postoperative analgesia , and nursing care programs in patients with a planned 2-day hospital stay , urinary catheter removal on the first postoperative morning , and epidural catheter removal on the second postoperative morning . Follow-up in the outpatient clinic was on days 8 and 30 . Results Nine patients needed bladder recatheterization , 8 as a single procedure and 1 patient a second recatheterization with removal on day 7 . This patient had urinary infection on day 10 and was readmitted for 5 days because of urosepsis and , subsequently , for cystitis and left-sided epididymitis . Three patients had uncomplicated urinary infection . No patients had urological complaints at 30 days follow-up ( 95 % confidence limit , 0 % to 3.6 % ) . Conclusion The low incidence of urinary retention ( 9 % ) and urinary infection ( 4 % ) suggests that routine bladder catheterization beyond postoperative day 1 may not be necessary in patients with ongoing continuous low-dose thoracic epidural analgesia
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .