Effects of epidural analgesia, regional blockade, and intravenous PCIA on early postoperative sleep disturbance and recovery outcomes after gastric and colorectal cancer surgery: a propensity score–based retrospective cohort study
Retrospective cohort study shows analgesic strategy influences sleep outcomes in cancer surgery, suggesting better approaches may improve recovery.
Key Points
This study aims to assess how different analgesic strategies affect early postoperative sleep disturbance and recovery in gastric and colorectal cancer surgery.
Retrospective cohort study of 860 patients undergoing gastric or colorectal cancer surgery
Patients received one of three postoperative analgesia methods: epidural analgesia, regional blockade, or intravenous PCIA
Outcomes analyzed included sleep disturbance, pain scores, opioids used, and recovery metrics using multivariable regression and propensity score methods.
Early postoperative sleep disturbance was reported in 55.3% of patients, with IV PCIA yielding the highest rates at 65.4% compared to 46.1% with epidural and 50.6% with regional blockade (P < 0.001)
Epidural analgesia and regional blockade were linked to lower odds of sleep disturbance compared to IV PCIA (adjusted OR 0.447 and 0.526, respectively, both P < 0.001)
Patients receiving epidural analgesia had a shorter length of stay compared to those with IV PCIA, approximately 0.9 days shorter.