Learning
Track: 8. Acute Pain Management
Title: Use of nonopioid
adjuvant analgesics for colorectal
surgery
Author(s): Patel S.1, Robertson B.2
Institute(s): 1Pennine Acute NHS Trust, Dept of Anaesthesiology, Rochdale, United Kingdom, 2Queen Elizabeth
Hospital, Dept of Anaesthesiology, Chirlie, United Kingdom
Text: Background and Goal of Study: Colorectal anaesthesia groupUK
(CAGUK)
organises annual
colorectal anaesthesia meeting. Our aim was to find out current practice of use of NOAA among
participants of 2016 meeting.
Materials and Methods: We distributed printed survey questionnaire form comprising of several
clinical question at the start on the day of meeting in April 2016. Eight clinical questions were
formulated by a member of CAGUK.
Questions were related to use of NOAA for nature of surgery
(elective or emergency, open or laparoscopic). Type of NOAA, likely does and duration of use were
asked. Inquiry was done whether NOAA are used as a part of enhanced recovery pathway and
whether there is a departmental guideline for NOAA or not. We excluded routinely used common
analgesics paracetamol and NSAIDs.
Results and Discussion: 83 forms were returned from 115 participants. 50%use NOAA for both
open and laparoscopic surgery. More participants used NOAA for only open (11%) then only
laparoscopic surgery. 35% used NOAA routinely while 28% never used any group of NOAA.
Majority (50%) have knowledge that NOAA are useful for enhanced recovery of colorectal surgical
patients, only 15% have guidelines for use of NOAA.
The use of NOAA was found to be variable among anaesthetists Gabapentin
15.8%, Pregabalin
12.1%, Clonidine 15.8%, Dexmedetomidine 3.6%, Ketamine 35.3%, Lidocaine 8.5%, Magnesium
17%, Dexamethasone 48.7%,
ER guidelines suggest avoiding opioids for acute pain relief due to potential side effects. NOAA can
be useful in the management of acute postoperative pain. However, except lidocaine infusion NOAA
for colorectal surgery are not well researched. Current practice for the use of NOAA for colorectal
surgical pain relief is not known in the UK.
Conclusions: Use of NOAA is not evidence based and is variable. There is a need for more
research for the use of various NOAA within enhanced recovery protocol.
References:
Ljungqvist O. ERASenhanced
recovery after surgery: moving evidencebased
perioperative care
to practice. JPEN. Journal of parenteral and enteral nutrition. 2014;38:55966.
Feldheiser A, Aziz O, Baldini G, Cox BP, Fearon KC, Feldman LS, Gan TJ, Kennedy RH, Ljungqvist
O, Lobo DN, Miller T. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2:
consensus statement for anaesthesia practice. Acta Anaesthesiologica Scandinavica.
2016;60(3):289334.
Ethical Research Declaration: 8. Survey
Preferred Presentation
Type: Clinical or experimental study

Use of non-opioid adjuvant analgesics for colo-rectal surgery