ASCRS Conference Coverage

Spinal Anesthesia Lowers Pain and Cost in Colorectal Surgery

Miranda Manier, BA

Key Highlights:

  • Spinal anesthesia (SA) significantly reduced postoperative pain at 3, 6, and 24 hours.
  • Patients receiving SA used less morphine in the first 3 hours after surgery.
  • SA was associated with shorter hospital stays and lower total costs.
  • No difference was observed in bowel function or rates of postoperative ileus.

In a prospective observational study of patients undergoing elective laparoscopic colorectal surgery, spinal anesthesia (SA) was found to significantly improve early postoperative pain control and reduce hospitalization costs. However, the use of SA did not impact postoperative bowel function or rates of ileus.

Spinal anesthesia is increasingly used alongside general anesthesia to reduce perioperative pain and potentially minimize systemic opioid use. This study, which was presented at the American Society of Colon & Rectal Surgeons Annual Scientific Meeting on May 11, 2025, aimed to assess whether those benefits also extend to improving gastrointestinal recovery and lowering overall hospitalization costs in colorectal surgery patients.

Beginning in June 2021, all patients undergoing colorectal surgery at a Swiss center were offered SA. The study included 170 patients treated between October 2021 and April 2024 who underwent elective, non-ostomy laparoscopic resections. Patients with a Charlson Comorbidity Index (CCI) over four or undergoing certain procedures were excluded. Pain scores, opioid use, bowel function markers, and costs were compared between 112 patients who received SA and 58 who did not.

SA was associated with lower median pain scores at 3 hours (0 vs 5; P = .009), 6 hours (2 vs 3; P = .004), and 24 hours (2 vs 5; P = .012) postoperatively. Morphine consumption in the first 3 hours was significantly lower in the SA group (0 mg vs 10 mg; P = .018). No significant differences were found in time to flatus, stool, or resumption of a normal diet, nor in rates of prolonged postoperative ileus. However, SA was linked to a shorter median hospital stay (6 vs 7 days; P = .038) and lower total costs (16,485 CHF vs 18,047 CHF; P = .044).

“Spinal anesthesia improves postoperative pain control and is associated with a decrease in hospitalization costs and length-of-stay,” the study authors concluded.

Reference
Wirsching A, Seidl AF, Krombholz E, et al. Spinal anesthesia decreases pain and total hospitalization costs but not ileus after colorectal surgery: a prospective observational study. Presented at: ASCRS Annual Scientific Meeting; May 11, 2025; San Diego, CA. Accessed April 25, 2025. https://ascrs25.eventscribe.net/