Continuous epidural infusion for postoperative pain relief: a comparison of three regimens

Journal of Anesthesia
S SakuraY Kosaka

Abstract

We evaluated the postoperative pain relief and side-effects of continuous epidural infusion of three analgesic regimens following major thoracic and/or abdominal surgery. One hundred and twenty patients were randomly divided into three treatment groups: (1) 0.25% or 0.5% bupivacaine at a rate of 3-7 ml.hr(-1), (2) 0.01% morphine at a rate of 1-2 ml.hr(-1), (3) a combination of 0.125% or 0.25% bupivacaine and 0.0025% or 0.005% morphine at a rate of 2-4 ml.hr(-1). The study continued for the first 48 postoperative hours. The effect of pain relief was evaluated by assessment of the further requirement for parenteral analgesics. Sixty-four percent of the patients given bupivacaine, 56% of the patients given morphine and 80% of the patients given the combination required no supplemental analgesics. Continuous epidural infusion of bupivacaine was associated with hypotension (21%) and with numbness and weakness of hands or legs (18%). Continuous epidural infusion of morphine was associated with pruritus (18%) and with peristaltic depression (12%). The combination regimen was associated with pruritus (17%) and with drowsiness (14%). We conclude that the combination of bupivacaine and morphine significantly provides superior analgesia w...Continue Reading

References

Jul 1, 1975·Canadian Anaesthetists' Society Journal·W M WahbaD B Craig
Jul 1, 1988·Anesthesia and Analgesia·T Thorén, M Wattwil
May 1, 1967·Anesthesiology·P R Bromage
Jan 1, 1984·Anesthesia and Analgesia·N Rawal, M Wattwil

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Citations

Jul 1, 1990·Journal of Anesthesia·S SakuraY Kosaka
Nov 28, 2013·The Cochrane Database of Systematic Reviews·Sheena DerryR Andrew Moore

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