Effect of peri‐ and postoperative epidural anaesthesia on pain and gastrointestinal function after abdominal hysterectomy
- 1 October 2001
- journal article
- clinical trial
- Published by Elsevier BV in British Journal of Anaesthesia
- Vol. 87 (4), 577-583
- https://doi.org/10.1093/bja/87.4.577
Abstract
In a double blind study we have investigated the effects of epidural local anaesthesia (LA), when added to general anaesthesia (GA) and postoperative paracetamol and NSAID, on postoperative pain and gastrointestinal function in patients undergoing open hysterectomy. Sixty patients were randomized into three study groups: GA, and postoperative paracetamol and NSAID (GA, n=20); GA, paracetamol, NSAID, intraoperative epidural lidocaine and 24-h postoperative epidural saline (Saline, n=20); or GA, paracetamol, NSAID, intraoperative epidural lidocaine and 24-h postoperative epidural bupivacaine (Bupi, n=20). Patients were observed for 72 h postoperatively. Pain at rest, during cough, and mobilization, request for supplementary morphine, and time to first postoperative flatus, was reduced in patients receiving 24-h postoperative epidural anaesthesia, compared with the two other groups. However, these effects of epidural LA, were not sustained beyond the period of infusion, and no differences in PONV, time to first postoperative defecation, mobilization or time to discharge from hospital were observed between groups. A 24 h postoperative epidural infusion with bupivacaine, when added to postoperative paracetamol and NSAID, reduces pain and opioid requirements, but has only limited effects on gastrointestinal function and patient recovery.Keywords
This publication has 15 references indexed in Scilit:
- Postoperative ileus: a preventable eventBritish Journal of Surgery, 2000
- Pretreatment with controlled-release morphine for pain after hysterectomyAnaesthesia, 1996
- A comparison of retrospective versus contemporaneous nausea scores with patient-controlled analgesiaAnaesthesia, 1996
- Effects of Perioperative Analgesic Technique on Rate of Recovery after Colon SurgeryAnesthesiology, 1995
- Balanced analgesia with intravenous ketorolac and patient-controlled morphine following lower abdominal surgeryJournal of Clinical Anesthesia, 1995
- Continuous epidural infusion of bupivacaine and morphine for postoperative analgesia after hysterectomyActa Anaesthesiologica Scandinavica, 1991
- Epidural analgesia in colonic surgery: Results of a randomized prospective studyBritish Journal of Surgery, 1990
- Effects of epidural bupivacaine and epidural morphine on bowel function and pain after hysterectomyActa Anaesthesiologica Scandinavica, 1989
- Effect of continuous postoperative epidural analgesia on intestinal motilityBritish Journal of Surgery, 1988
- The effect of bupivacaine and morphine on pain and bowel function after colonic surgeryActa Anaesthesiologica Scandinavica, 1987