Methods
Participants
A total of 32 consecutive patients attending the department
of surgery for an elective colon resection were invited to
participate in this study. Ethical approval was obtained
from the Research Ethical Committee at the University of
Go¨ teborg. On the day before surgery, the patients were
informed about the aims of the study. Informed consent was
obtained.
All patients were kept in one 24-bed ward, with a regular
staff. During the operations, standard anaesthesia and a
thoracic epidural were used, and a minimum number of nurse
anaesthetists handled the participants in the operating room.
Both laparoscopic and open procedures were chosen, because
Kelhet and co-workers have described the same results for
both these groups of patients (Kehlet & Dahl 2003). The
surgery was performed in 2006–2007. The inclusion criterion
was an elective colon resection with an ASA score I–III
(Owens et al. 1978). The exclusion criteria were inability to
understand the Swedish language and mental disorders such
as dementia. Patients scheduled for rectal surgery and total
colectomy were also excluded.
The fast-track concept
This concept is used in most elective colon resections, either
open or laparoscopic. The fast-track concept includes the
following: verbally and written preoperative information, no
bowel preparation, preoperative oral hydration, no sedatives,
preoperatively activated thoracic epidural analgesia (EDA),
short-acting sleeping agents and no morphine analgesics in the