Preoperative infiltration of the surgical area enhances postoperative analgesia of a combined low-dose epidural bupivacaine and morphine regimen after upper abdominal surgery

J Bartholdy; K Sperling; M Ibsen; K Eliasen; T Mogensen

doi:10.1111/j.1399-6576.1994.tb03886.x

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Preoperative infiltration of the surgical area enhances postoperative analgesia of a combined low-dose epidural bupivacaine and morphine regimen after upper abdominal surgery

Journal article

Peer reviewed

Preoperative infiltration of the surgical area enhances postoperative analgesia of a combined low-dose epidural bupivacaine and morphine regimen after upper abdominal surgery

J Bartholdy, K Sperling, M Ibsen, K Eliasen and T Mogensen

Acta anaesthesiologica Scandinavica, Vol.38(3), pp.262-265

04/1994

DOI: 10.1111/j.1399-6576.1994.tb03886.x

PMID: 8023667

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Abstract

In a randomized, blinded trial we assessed the value of adding preoperative infiltration of the surgical area with bupivacaine to a low dose epidural regimen for postoperative pain treatment. Forty-nine patients scheduled for major upper abdominal surgery during combined thoracic epidural (bupivacaine + morphine) and general anaesthesia were studied. Postoperative analgesia was epidural bupivacaine 10 mg/hr-1 + morphine 0.2 mg/hr-1 for 72 h. The patients randomly received preoperative infiltration of the surgical area with bupivacaine 0.25%, 40 ml (group I); or no infiltration (group II). Pain was evaluated at rest, during cough and during mobilization six and eight h after start of surgery, and at 8 a.m. and 4 p.m. on the following days until 72 h after start of surgery. The sensory level of analgesia was evaluated by pin prick. We found no difference between the two groups during rest and cough. However, during mobilization group I had lower pain scores compared to group II (P < 0.05). There was a significant reduction in the need for supplemental intramuscular morphine in the treatment group compared to the control group (P < 0.05). Thus an enhanced analgesic effect was demonstrated by adding preoperative infiltration of the surgical area with local anaesthetic to a low dose epidural bupivacaine/morphine regimen after upper abdominal surgery.

Cough - physiopathology

Double-Blind Method

Analgesia - methods

Humans

Middle Aged

Analgesia, Epidural

Bupivacaine - administration & dosage

Injections, Intramuscular

Abdomen - surgery

Preoperative Care

Dermatologic Surgical Procedures

Pain, Postoperative - prevention & control

Movement - physiology

Posture - physiology

Injections, Subcutaneous

Adult

Aged

Pain Measurement

Morphine - administration & dosage

Drug Combinations

Details

Title: Subtitle: Preoperative infiltration of the surgical area enhances postoperative analgesia of a combined low-dose epidural bupivacaine and morphine regimen after upper abdominal surgery
Creators: J Bartholdy - Department of Anaesthesiology, Herlev Hospital, University of Copenhagen, Denmark
K Sperling
M Ibsen
K Eliasen
T Mogensen
Resource Type: Journal article
Publication Details: Acta anaesthesiologica Scandinavica, Vol.38(3), pp.262-265
Publisher: England
DOI: 10.1111/j.1399-6576.1994.tb03886.x
PMID: 8023667
ISSN: 0001-5172
eISSN: 1399-6576
Language: English
Date published: 04/1994
Academic Unit: Anesthesia
Record Identifier: 9984007176302771

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