Regional Anesthesia in Colon Rectal Surgery

The study population will consist of patients who are scheduled for open laparoscopic or
laparoscopic assisted surgery for colon cancer. Patients will randomized into one of two
groups. The intervention group will receive combined regional and general anesthesia during
surgery. Postoperative pain treatment will be based on regional anesthesia techniques. The
Control group will receive general anesthesia during surgery. Postoperative pain treatment
will be based primarily on opioids. After surgery, patients will be followed daily during
their hospital stay. Patients will be contacted by telephone every 6 months for five years.
Quality of life questionnaires will be administered at these follow ups.

Inclusion Criteria:

- Primary colon cancer without known extension beyond colon (T3, N0, M0)

- Scheduled for open, laparoscopic assisted and laparoscopic resection of the colon.

- Written informed consent, including willingness to be randomized to epidural
anesthesia/analgesia or to sevoflurane general anesthesia and postoperative opioid
analgesia.

Exclusion Criteria:

- Previous surgery for colon cancer;

- Any contraindication to epidural anesthesia or analgesia (including coagulopathy,
abnormal anatomy);

- Any contraindication to midazolam, propofol, sevoflurane, fentanyl, or morphine;

- Age <18 or >85 years old;

- ASA Physical Status ≥4;

- Other cancer not believed by the attending surgeon to be in long-term remission;

- Systemic disease believed by the attending surgeon or anesthesiologist to present
≥25% two-year mortality.