The Stress Response in Laparoscopic Colorectal Surgery and Its Role in the Development of the Enhanced Recovery Program.

Exclusion Criteria

• •Stoma formation (previous research at the MATTU has shown that the formation of a stoma significantly affects the quality of life to the degree that there is no difference between open and laparoscopic surgery)
• •* Conversion to a traditional open operation (removes the elements of keyhole surgery)
• •* Contraindication to spinal anaesthesia: abnormal clotting, skin infection over or near the back, presence of neurological disorders or anatomical abnormalities of the vertebral column. (For patient safety)
• •* Contraindication to the use of oesophageal Doppler: oesophageal disease, recent oesophageal surgery or upper airway surgery, moderate to severe aortic valve disease and any condition that causes bleeding problems. (For patient safety)
• •* Diagnosis of diabetes mellitus (will confound the stress response analysis)
• •* Treatment with exogenous steroids in the proceeding 3 months (will confound the stress response analysis)