Measuring the quality of continuous epidural block for abdominal surgery

British Journal of Anaesthesia
G A McLeodJ A W Wildsmith

Abstract

In view of the wide variation in pain experience between patients, a clinical standard -- the time from the end of surgery to the first experience of pain -- was applied to 1359 consecutive patients in order to investigate whether the initial quality of epidural block has an effect on the overall quality of postoperative pain relief. Clinical data were recorded in 58,118 out of 72,412 h in 1359 patients, and transferred to a database. Data collected included pain scores on a four-point verbal rating scale; nausea and vomiting; motor block; sedation scores; systolic blood pressure <100 and <90 mm Hg; ventilatory frequency <10 and <8 bpm; and hourly epidural infusion rate. As the time to first experience of pain increased from nil to >24 hours, the time from the first to last experience of pain shortened from 34 (19-50) h to 3 (1-12) h (p<0.001) and the proportion of patients receiving an epidural bolus decreased from 53 to 8% (p<0.001). Increases in the initial pain free time increased the proportion of patients with systolic BP<100 mmHg from 59 to 77%, (p<0.001) and increased the proportion of patients with respiratory rate <10 bpm from 13 to 26%, (p<0.001). Extending pain relief for more than 12 h beyond the end of abdominal s...Continue Reading

References

Feb 26, 2000·Anesthesiology·J C Eisenach
Oct 6, 2000·Anesthesiology·I Kissin
Feb 27, 2001·BMJ : British Medical Journal·D W Wilmore, H Kehlet
Apr 20, 2002·Lancet·John R A RiggUNKNOWN MASTER Anaethesia Trial Study Group

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Citations

Feb 26, 2011·Der Anaesthesist·X LiuH Wang
Aug 5, 2010·Revista brasileira de anestesiologia·Luiz Eduardo ImbelloniJosé Antonio Cordeiro
Jan 14, 2009·British Journal of Anaesthesia·T M CookUNKNOWN Royal College of Anaesthetists Third National Audit Project
Mar 21, 2015·British Journal of Anaesthesia·M D Stoneham, J Quinlan
Jun 5, 2007·Journal of Cardiothoracic and Vascular Anesthesia·Komal PatelRichard Kowalewski
Aug 31, 2018·The Cochrane Database of Systematic Reviews·Jon H SalicathMichael H Bennett
Jul 11, 2007·Current Opinion in Anaesthesiology

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