Laparoscopy Clinical Trial
Official title:
The Stress Response in Laparoscopic Colorectal Surgery and Its Role in the Development of the Enhanced Recovery Program.
Keyhole bowel surgery provides the patient with an improved outcome following surgery in
comparison to more traditional surgery requiring a large cut. In order to further improve
outcomes there are several variables that must be controlled before, during and after the
operation. These variables are the correct pain relief, accurate control and measurement of
the fluid that is given during the operation and the subsequent mobility following surgery.
Previous research has already identified that an enhanced recovery program (careful control
and structure to the patients journey) will reduce the length of stay and complications
after an operation. Currently an integral part of the enhanced recovery program requires the
use of an epidural (a thin tube in the spine) to provide continuous pain relief for up to 48
hours. Through research previously undertaken at the MATTU the investigators have shown that
an epidural can lead to an increase in the length of stay and a delay in the return to
normal bowel function. A reason for the use of an epidural is to suppress the stress
response.
The investigators aim to recruit patients from outpatient clinic undergoing keyhole bowel
surgery in one unit and randomize them to receive one of two different pain relief methods
after the operation. Patients will follow the same care as standard patients but their pain
relief will differ between two already well established modalities. They will also receive
different intravenous fluids. Blood will also be drawn at various intervals immediately
after the operation for future analysis. The trial will be funded by the MATTU and will run
for approximately 18 months. This trial will enable us to establish the stress response in
the four groups and correlate it to the patient's outcome with an aim to refining the
enhanced recovery program.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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