Types of multimodal analgesia in surgical treatment of colorectal cancer

Ye.A. Gorkavyi, І.І. Lisnyi


Background. The purpose of the research was to study the efficacy and safety of various types of multimodal analgesia in the surgical treatment of colorectal cancer. Materials and methods. The study included 90 patients operated for rectal cancer. The ana­lysis of changes in hemodynamics, stress marker level — blood sugar and pain intensity on the visual analogue scale was carried out in three groups of patients depending on the method of perioperative analgesia. Results. The study found that the application of various types of multimodal analgesia using epidural analgesia (EA) with inhalation and intravenous anesthesia more effectively protects the patient from surgical stress in colorectal cancer as compared to the total intravenous anesthesia, preserves hemodynamic stability, reduces the dose of fentanyl and muscle relaxants. Conclusions. EA with a mixture of local anesthetic with fentanyl, and EA with a local anesthetic with patient-controlled fentanyl analgesia in combination with a pa­renteral non-steroidal anti-inflammatory drug and paracetamol as components of multimodal analgesia is safe for postope­rative use after colorectal surgeries, effectively controls acute postope­rative pain, maintains a stable level of the blood sugar in comparison with postoperative omnopon anesthesia.


multimodal analgesia; epidural analgesia; non-steroidal anti-inflammatory drug; paracetamol; surgical stress; postoperative pain


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