Impact of preoperative treatment with antidepressants and/or anxiolytics on outcomes after colorectal surgery with an enhanced recovery programme: a monocentric retrospective study

# Accepted at the 2020 SFAR (Société française d’anesthésie et de réanimation) annual meeting for abstract presentation, September 24, 2020 (cancelled due to the COVID crisis).

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Abstract

Background

Preoperative use of antidepressants and anxiolytics was reported to increase length of hospital stay (LOS) and worsen surgical outcomes. However, the surgical procedures studied were seldom performed with an enhanced recovery programme (ERP). This study investigated whether these medications impaired postoperative recovery after colorectal surgery with an ERP.

Methods

The data of all patients scheduled for colorectal surgery between November 2015 and December 2019 prospectively included in our database were analysed. All the patients were managed with the same ERP. Demographic data, risk factors, incidence of postoperative complications, LOS, and adherence to the ERP were compared between patients with and without preoperative antidepressant and/or anxiolytic treatment.

Results

Of the 502 patients, 157 (31.3%) were treated with antidepressants and/or anxiolytics. They were older (65.7 vs. 59.5 years, p < 0.001), sicker (higher ASA physical status score, p = 0.001), and underwent surgery more frequently for cancer (73.9 vs. 56.8%, p < 0.001). Overall adherence to ERP (p = 0.99) and adherence to the postoperative items of ERP (p = 0.29), incidence of postoperative complications (35.7 vs. 33.2%, p = 0.61), and LOS (4 [2–7] vs. 4 [2–7], p = 0.99) were similar in the two groups.

Conclusions

Our findings suggest that preoperative treatment with antidepressants and/or anxiolytics does not worsen outcome after elective colorectal surgery with an ERP, does not impact adherence to ERP, and does not prolong LOS. ERP seems efficacious in patients treated with these medications, who should therefore not be excluded from this programme.

Keywords:

• antidepressants
• anxiolytics
• colorectal surgery
• enhanced recovery program
• length of stay
• postoperative complications

Author contributions

PYH and AB contributed equally to the conception and design of the work, and the acquisition, analysis, and interpretation of data for the work. MHB: acquisition, analysis, and interpretation of data for the work. GH: statistical analysis and interpretation of data for the work. JJ: study conception and design, acquisition, statistical analysis, interpretation, first draft of the paper. All the authors critically revised the draft, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

# Accepted at the 2020 SFAR (Société française d’anesthésie et de réanimation) annual meeting for abstract presentation, September 24, 2020 (cancelled due to the COVID crisis).

Additional information

Funding

This study received financial support from GRACE (Francophone Group for Enhanced Recovery after Surgery, Beaumont, France, www.grace-asso.fr). The funding source had no involvement in study design, in collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the article for publication.