FP4.13 - Intravenous morphine negatively affects length of stay following minimally invasive colorectal surgery

Abstract Aim Investigate the impact of intravenous (IV) morphine administered as patient controlled analgesia (PCA) following minimally invasive colorectal resections. Method Demographic, peri-operative and follow-up data from a prospectively maintained database were collected for all laparoscopic and robotic assisted colorectal procedures carried out at our centre. Results Our cohort included 38 colorectal resections completed with the DaVinci Xi (Intuitive Surgical, USA) robotic platform and 57 consecutive laparoscopic colorectal resections. 7 patients were excluded due to incomplete data. 51/88 (57.9%) of patients underwent a left sided resection and 24/88 (27.3%) had a stoma formed. We observed a median IV morphine dose of 15.5mg (IQR 15.5-43.5mg) and we sub-divided the cohort into those who received >15 mg of IV morphine and <15mg of morphine via PCA. Patients who received <15mg IV morphine were older (median age 75 Vs 67 years; p<0.001). There was no statistical difference in the body mass index, ASA grade, total operative time, or type of minimally invasive resection. The median length of stay was 4 days for the <15mg IV Morphine cases compared to 5 in the >15mg IV Morphine group (p<0.001). As expected, there was a quicker time to first flatus in the <15mg IV Morphine group (median 2 days Vs 3 days; p<0.001) and a shorter time to opening bowels (median 3 days Vs 4 days; p=0.003). There was no statistically significant difference in post-operative complications between the two groups. Conclusions Reducing postoperative IV Morphine dosing following minimally invasive colorectal resections may lead to prompter recovery.