Pre- and intraoperative epidural ropivacaine have no early preemptive analgesic effect in major gynecological tumour surgery

Abstract

P Pu ur rp po os se e: : Thoracic epidural analgesia (TEA) is an established technique for postoperative pain relief after major abdominal surgery. However it is still under discussion whether pre-incisional TEA can reduce postoperative pain perception or postoperative analgesic consumption. M Me et th ho od ds s: :The present prospective, randomized, double-blind study was performed to investigate the effects of intra-and postoperative TEA vs only postoperative TEA using ropivacaine 0.375% in 30 women scheduled for major abdominal tumour surgery. Prior to induction of general anesthesia patients received an epidural bolus of 10 mL saline in Group I (GI) and 10 mL ropivacaine 0.375% in Group II (GII) followed by an infusion of 6 mL·hr -1 of the respective solution during surgery. Postoperatively all patients received an epidural infusion of 6 mL·hr -1 ropivacaine 0.375% during 24 hr followed by patient controlled epidural analgesia for the next 72 hr. Operative data, dynamic pain scores, consumption of local anesthetics and standardized supplemental analgesics were analyzed. R Re es su ul lt ts s: : No difference was seen between groups with respect to the amount of required postoperative local anesthetics and supplemental analgesics, pain scores and side effects during the first 96 hr following surgery except a reduction of intraoperative sufentanil consumption (GI: 143.2 ± 52.6 vs GII: 73.3 ± 32.6 µg, P < 0.001).C Co on nc cl lu us si io on n: : Intraoperative TEA with ropivacaine 0.375% did not significantly reduce the amount of analgesics required after major abdominal gynecological tumour surgery. (GI : 143,2 ± 52,6 vs GII : 73,3 ± 32,6 µg, P < 0,001 Objectif : L'analgésie péridurale thoracique (APT) est

Effects of Combined Epidural Analgesia with Total Intravenous Anesthesia on Risky Patients Underwent Major Abdominal Surgery

“…[8][9][10] TIVA is well documented with regard to effect, tolerability and safety. [11][12][13][14] Combination of epidural and general anesthesia is proposed to be associated with more rapid recovery, [15,16] reduced blood loss, [17] reduced risk of venous thrombosis, [18] early mobilization of the patient [19,20] and shortened stay in intensive care units. [19,21,22] The bispectral index score (BIS) has been proven to correlate well with the hypnotic state of the patient during both inhaled and IV anesthesia.…”

Long-Lasting Analgesic Effects of Intraoperative Thoracic Epidural With Bupivacaine for Liver Resection

“…Forty-four patients scheduled for major liver resection (Q2 segments) were recruited. Patient-controlled analgesia morphine consumption, pain at rest and with movement, sedation, nausea, pruritus, and respiratory frequency were evaluated at 6,9,12,18,24, 36, and 48 hrs after intrathecal morphine injection.Results: Patients in the placebo group consumed twice as much morphine during each time interval than patients in the epidural group (at 48 hrs: 123 [SD, 46] vs 59 [SD,25] mg; P G 0.0001). Pain evaluation on visual analog scale at rest and on movement was lower in the epidural group (P = 0.017 and P = 0.037).…”

“…Results: Patients in the placebo group consumed twice as much morphine during each time interval than patients in the epidural group (at 48 hrs: 123 [SD, 46] vs 59 [SD,25] mg; P G 0.0001). Pain evaluation on visual analog scale at rest and on movement was lower in the epidural group (P = 0.017 and P = 0.037).…”

Die peridurale Anwendung von Ropivacain und Clonidin zur Schmerztherapie nach Prostatektomie

“…Die thorakale peridurale Anästhesie ist ei ne bevorzugte Methode für die postopera tive Analgesie nach großen abdominellen Operationen [3]. Sie ermöglicht eine aus gezeichnete Analgesie nach großen Ein griffen, ist aber nicht ohne Nebeneffekte [18].…”