EPIDURAL ANALGESIA SHORTENS POSTOPERATIVE ILEUS AFTER ILEAL POUCH-ANAL CANAL ANASTOMOSIS

PURPOSE: A retrospective study was conducted to determine whether epid ural analgesia would speed recovery from postoperative ileus in patien ts undergoing ileal pouch-anal canal anastomosis. METHODS: Among 85 pa tients who underwent proctocolectomy with ileal pouch-anal canal anast omosis at the Mayo Medical Center between January 1, 1991 and October 31, 1992, 44 were treated for postoperative pain with continuous infus ion of epidural fentanyl citrate supplemented by intravenous morphine on request, while 41 controls were given only systemic morphine sulfat e as needed. RESULTS: The patients in the two groups were matched and similar with regard to preoperative and operative risk factors and pos toperative morbidity, No operative mortality occurred, Epidural fentan yl analgesia resulted in less need for nasogastric suction and intrave nous fluids, more rapid discharge of fecal content, more rapid return to oral intake, and shorter hospitalization. CONCLUSION: Epidural anal gesia with fentanyl citrate shortened postoperative ileus after procto colectomy and ileal pouch-anal canal anastomosis.