Episode 9: Role of Regional Anesthesia and Analgesia in Enhanced Recovery After Colorectal Surgery

In surgical care worldwide, there has been a growing trend towards enhanced recovery with the emphasis on early mobility, avoidance of unnecessary procedures and drug-induced side effects, and faster return of normal gastrointestinal function, with the end result of shorter hospital stay. It’s natural to assume that regional anesthesiology and acute pain medicine would play a central role in enhanced recovery protocols for all of the well-described benefits. However, the base evidence is continually evolving as both anesthetic and surgical practices change. In this month’s RAPM Focus, Associate Editor Edward Mariano, MD, joins Kariem El-Boghdadly, MBBS, BSc, FRCA, EDRA, lead author of an international collaboration in the regional anesthesiology and enhanced recovery world, “Role of regional anesthesia and analgesia in enhanced recovery after colorectal surgery: a systematic review of randomized controlled trials,” first published in March 2022 (https://rapm.bmj.com/content/47/5/282). Investigators carefully evaluated thirteen published randomized controlled trial studies involving 1,170 participants and concluded that regional analgesia may only have modest evidence to support its inclusion in enhanced recovery protocols involving colorectal surgery patients. Dr. Kariem El-Boghdadly is a consultant anesthetist at Guy’s and St. Thomas’ NHS Trust in London, and an editor of the journal Anesthesia. Dr. El-Boghdadly completed his undergraduate training at University College of London in 2007 and proceeded to undertake his anesthetic training in Southeast School of Anesthesia. He was awarded the Nuffield Prize for the fellowship of the Royal College of Anaesthetists and completed fellowships in prehospital medicine in Australia, followed by regional anesthesia in Toronto, Canada. Dr. El-Boghdadly is an honorary senior lecturer at King’s College London, and his research interests include regional anesthesia, airway management, and research delivery. He is a brilliant researcher and writer and is well-known for his w