Table 2.
Non‐analgesic outcomes and current issues reported after abdominal surgery with different analgesic techniques
| Analgesia technique | Outcomes | ERAS | Control group | Complications/issues | |
|---|---|---|---|---|---|
| Laparotomy | TEA (low dose of LA and opioids) | ↓ PONV250 | – | SO | Hypotension, pruritus, bladder dysfunction248, 249 |
| ↑Recovery of bowel function244 | – | SO | |||
| ↓Insulin resistance246 | – | SO | |||
| ↓Respiratory complications247 | – | SO | |||
| ↑Health‐related quality of life353 | – | SO | |||
| = LOSH250 | – | SO | |||
| IT morphine | Health‐related quality of life354 | ✓ | SO | Respiratory depression, pruritus, bladder dysfunction265 | |
| IVLI | Anti‐inflammatory269 | – | SO | LA toxicity270 | |
| ↑Recovery of bowel function269 | – | SO | |||
| ↓LOSH269 | – | SO | |||
| = LOSH254 | ✓ | TEA | |||
| CWI LA | ↓/↑/= Recovery of bowel function275, 276, 277, 355 | ✓/– | SO;TEA | Ideal anatomic location not determined274 | |
| ↓/↑/= LOSH273, 275, 276 | – | SO;TEA | |||
| Abdominal trunks blocks | ↓Postoperative sedation284, 289 | – | SO | Timing, dose, volume of LA, technique297 | |
| ↓PONV283 | – | SO | |||
| Laparoscopy | TEA | ↑/=/↓ Recovery of bowel function243, 253, 254 | ✓/– | SO;IVLI;IT/TAP | Hypotension, pruritus, bladder dysfunction248, 249 |
| ↑/= LOSH253, 254 | ✓ | SO;IT;TAP | |||
| IT morphine | = Recovery of bowel function253, 268, 356 | ✓ | SO;TEA | Respiratory depression, pruritus, bladder dysfunction265 | |
| Facilitate mobilization356 | ✓ | TEA | |||
| ↓/= LOSH253, 268 | ✓ | SO;TEA | |||
| 23‐h LOSH after laparoscopic colectomy357 | ✓ | – | |||
| IVLI | Anti‐inflammatory269(↓ IL‐6, IL1‐R) | – | SO | LA toxicity270 | |
| ↑/= Recovery of bowel function254, 272 | ✓ | SO;TEA | |||
| = LOSH254 | ✓ | TEA | |||
| Abdominal trunksblocks | 23‐h LOSH after laparoscopic colectomy286 | ✓ | SO | Timing, dose and volume of LA, technique297 | |
| = LOSH295 | ✓ | SO | |||
| = LOSH, earlier urinary catheter removal296 | ✓ | TEA |
↓, decreasing; ↑, accelerating; =, no effect. SO, systemic opioids; TEA, thoracic epidural analgesia; IVLI, intravenous lidocaine infusion; CWI, continuous wound infusion; LA, local anaesthetic; LOSH, length of hospital stay in hospital; (ERAS), study within an ERAS programme.