Multimodal analgesia as part of enhanced recovery after surgery in colorectal surgery

Introduction: Multimodal analgesia regime in enhanced recovery after surgery (ERAS) protocol is associated with fewer perioperative complications, shorter hospital stays, and reduced opioid dependence. Although ERAS strategies have been widely accepted and implemented in current practice, there is limited data regarding its application and outcomes in the Malaysian population, particularly in colorectal surgeries. Hence, this study was conducted to examine postoperative pain scores after implementing a multimodal analgesia regime as per ERAS anaesthesia protocol. Methods: This is a retrospective study using data collection forms. Data were collected from the case notes of patients who underwent colorectal surgery complying with the ERAS anaesthesia protocol from January 2022 to December 2023. Pain score was assessed when the patient arrived at recovery bay, subsequently reassessed at 2 hours postoperative, 6 hours postoperative, 12 hours postoperative, 1 day postoperative, and finally on postoperative day 2. Results: A total of 139 samples were recruited in this retrospective study. The median postoperative pain scores at rest were consistently 0 from arrival at recovery bay to postoperative day 2. On the other hand, the median pain score upon movement was 1 (range 0–3) when patients reached the recovery bay, and persistently 3 duringpostoperative 2 hours, 6 hours, and 12 hours, after which the median pain score upon movement became 2 on postoperative day 1 and day 2. Conclusions: Multimodal analgesia in line with the ERAS protocol in colorectal surgeries is feasible, safe and efficient.