Clinical effect of multimodal perioperative pain management protocol for minimally invasive colorectal cancer surgery: Propensity score matching study

Background: Reducing postoperative pain with less opioid is critical in postoperative care. Author developed our multimodal perioperative pain management protocol and it consists of preoperative medication, intraoperative ultrasound-guided laparoscopic transverse abdominis plane (LTAP) block and postoperative medication. This study aimed to evaluate the clinical effect of the multimodal perioperative pain management protocol for minimally invasive colorectal cancer surgery. Methods: Of 596 colorectal surgery cases for colorectal cancer, 133 patients managed with multimodal perioperative pain protocol (group 1) and 463 patients managed without multimodal perioperative pain protocol (group 2) were enrolled in this study. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM). Results: After 1:1 propensity score matching, well-matched 133 patients in each group were evaluated. The median VAS scores on post-operative day 1 (2.1 +/- 1.1 vs. 3.9 +/- 1.8, p < 0.001) and day 2 (2.0 +/- 1.2 vs. 3.8 +/- 1.7, p < 0.001) was significantly reduced in group 1. The length of postoperative hospital stays was also significantly shorter in Group 1 (4.4 +/- 3.0 vs. 5.8 +/- 5.6; p = 0.014). Conclusion: Implementing multimodal perioperative pain protocols reduced postoperative pain and hospital stay of minimally invasive colorectal surgery. (C) 2020 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.

Automated summary

The study showed that implementing a multimodal perioperative pain management protocol significantly reduced postoperative pain and shortened the length of postoperative hospital stays for minimally invasive colorectal cancer surgery.