Differences in pain relief after open or laparoscopic colorectal cancer surgery with epidural or intravenous medication

Background and study aims
During the years 2013 - 2016 for colonic cancer the standard operating technique in our hospital changed from mainly open to laparoscopic (keyhole surgery) and therefore also the choice of pain relief used during and after the surgery might have changed. We choose to study the period between 2014 and 2016 to evaluate this change in pain treatment and the possible consequences, in addition to changed operating technique, for all patients admitted with this pathology. We tried to answer questions regarding pain treatment, length of stay, complications and 5-year survival.
Who can participate?
All patients scheduled for colonic cancer surgery in an academic tertiary hospital during the years 2014 till 2016.
What does the study involve?
Records were reviewed. The primary outcome of our study was the difference of pain in patients receiving open or laparoscopic interventions with either thoracic epidural (TEA) or intravenous opioid pain (PCIA) relief management. Because it was an observational study there were no benefits or risks for the participants. The study was performed in Maastricht, The Netherlands.
Data collection was prospectively recorded in two different data collection systems. Prospective collected data from the Dutch Surgical Colorectal Audit database (DSCA) were combined with prospective collected data from the acute pain service (APS) and the anesthesia registration system. Data analysis started after approval from the medical ethic committee.