Differences in epidural and analgesic use in patients with apparent stage I endometrial cancer treated by open versus laparoscopic surgery: results from the randomised LACE trial

Baker, Jannah, Janda, Monika, Belavy, David and Obermair, Andreas (2013) Differences in epidural and analgesic use in patients with apparent stage I endometrial cancer treated by open versus laparoscopic surgery: results from the randomised LACE trial. Minimally Invasive Surgery, . doi:10.1155/2013/764329

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Author Baker, Jannah
Janda, Monika
Belavy, David
Obermair, Andreas
Title Differences in epidural and analgesic use in patients with apparent stage I endometrial cancer treated by open versus laparoscopic surgery: results from the randomised LACE trial
Journal name Minimally Invasive Surgery   Check publisher's open access policy
ISSN 2090-1445
2090-1453
Publication date 2013
Year available 2013
Sub-type Article (original research)
DOI 10.1155/2013/764329
Open Access Status DOI
Total pages 5
Place of publication New York, United States
Publisher Hindawi Publishing Corporation
Collection year 2014
Language eng
Formatted abstract
Objectives. We compared postoperative analgesic requirements between women with early stage endometrial cancer treated by total abdominal hysterectomy (TAH) or total laparoscopic hysterectomy (TLH).

Methods. 760 patients with apparent stage I endometrial cancer were treated in the international, multicentre, prospective randomised trial (LACE) by TAH (n=353) or TLH (n=407) (2005-2010). Epidural, opioid, and nonopioid analgesic requirements were collected until ten months after surgery.

Results. Baseline demographics and analgesic use were comparable between treatment arms. TAH patients were more likely to receive epidural analgesia than TLH patients (33% versus 0.5%, P<0.001) during the early postoperative phase. Although opioid use was comparable in the TAH versus TLH groups during postoperative 0-2 days (99.7% versus 98.5%, P=0.09), a significantly higher proportion of TAH patients required opioids 3-5 days (70% versus 22%, P<0.0001), 6-14 days (35% versus 15%, P<0.0001), and 15-60 days (15% versus 9%, P=0.02) after surgery. Mean pain scores were significantly higher in the TAH versus TLH group one (2.48 versus 1.62, P<0.0001) and four weeks (0.89 versus 0.63, P=0.01) following surgery.

Conclusion. Treatment of early stage endometrial cancer with TLH is associated with less frequent use of epidural, lower post-operative opioid requirements, and better pain scores than TAH.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article number 764329.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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Created: Thu, 28 Nov 2013, 18:10:30 EST by System User on behalf of School of Medicine