Effect of Regional Analgesia on Wound Healing and Surgical Site Infection Following Colorectal Surgery: A Prospective Randomised Comparative Study

Background: Surgical site infection (SSI) continues to be a significant contributor to postoperative complications after colorectal procedures. Regional analgesia could facilitate wound healing by diminishing the surgical stress response, augmenting tissue perfusion, and lowering opioid usage. The aim is to assess the impact of thoracic epidural analgesia on wound recovery and the incidence of surgical site infections after elective colorectal procedures. Material and Methods: In this demonstrative prospective randomised comparative study, 100 patients scheduled for elective colorectal surgery were assigned to receive either thoracic epidural analgesia combined with general anaesthesia (Group E, n=50) or intravenous opioid analgesia alongside general anaesthesia (Group C, n=50). The principal outcomes encompassed the incidence of surgical site infections and wound healing evaluated through the ASEPSIS score. Secondary outcomes encompassed pain assessments, opioid usage, inflammatory indicators, gastrointestinal recovery, and duration of hospitalisation. Results: Group E exhibited a diminished simulated SSI rate (8% versus 22%; P=0.041), superior wound healing scores (P <0.001), decreased pain scores, less opioid usage, expedited bowel recovery, and a briefer hospital stay in comparison to Group C. Conclusion: Thoracic epidural analgesia could improve postoperative wound recovery and decrease surgical site infections after colorectal surgery, while also offering enhanced pain relief. Additional multicentre randomised studies are necessary to validate these results.

Keywords: Thoracic epidural anaesthesia; colorectal operation; surgical site infection; wound recovery; regional anaesthesia.