| Abstract [eng] |
Summary in English Language Objective: For recovery after laparoscopic colorectal surgery, adequate postoperative pain management is crucial. Particularly in the field of laparoscopic surgeries as opposed to open surgeries not only focussing on reduced surgical trauma but also on postoperative pain, opioid-related adverse effects and various other factors are essential. The objective of this paper was to evaluate procedure-specific postoperative pain management in laparoscopic surgeries setting a clear focus on changes between the two latest Enhanced Recovery After Surgery Guidelines, opioid-sparing effects and their impacts on postoperative recovery as well as pain management in robotic surgeries. Materials and Methods: A narrative literature review using PubMed, Google Scholar and ClinicalKey as most of the databases was carried out. Most of the publications included in this paper have been published between 2015 and 2025, giving a few exceptions being older. Particular focus has been carried out on the Enhanced Recovery After Surgery Guidelines from 2018 and 2025. Key topics of this paper contain a multimodal analgesia approach, regional anaesthetic techniques, as well as comparing opioid-based with opioid-sparing strategies. Inclusion criteria: Studies in English language, systematic reviews, multi- and single-centred small- and large scale studies, practice guidelines, particularly the latest two versions of Enhanced Recovery After Surgery Guidelines 2018 and 2025, studies involving patients that underwent laparoscopic or robotic-assisted colorectal surgery, studies that assess the postoperative pain management in laparoscopic colorectal surgery, studies comparing two or more different approaches of postoperative analgesia in laparoscopic colorectal surgery. Exclusion criteria: Case presentations, articles in other languages than English, ethically not acceptable studies, not providing adequate analgesia to the patients, patients that underwent other surgeries as abdominal or thoracic surgeries Key words: Laparoscopic colorectal surgery; postoperative pain management; length of stay; anaesthesiology; opioid-sparing analgesia Conclusion: Using adequate multimodal analgesia protocols is one of the most important aspects in laparoscopic colorectal surgery. The most of the discussed analgesic techniques are not sufficiently effective when used as monotherapy and may be associated with considerable adverse events. Combining specific techniques as regional anaesthesia together with non-opioid systemic analgesia is prone to be beneficial and may lead to a reduction of opioid necessity which may furthermore lead to enhanced recovery and better outcomes. Recent data supports the use of Enhanced Recovery After Surgery protocols as an important standard. Although, there is still a lack of large, randomized trials especially in robotic-assisted colorectal surgery to draw a clear conclusion and optimise pain management strategies. |
