The effects of epidural bupivacaine administration for postoperative pain after major abdominal surgery
Keywords:Epidural analgesia, Bupivacaine, Major abdominal surgery
Aim: Postoperative pain is a major problem after major abdominal surgery and conventional intramuscular analgesic therapy is usually not enough. We investigated the effectiveness and timing of epidural patient control analgesia on intraoperative analgesic consumption and postoperative pain, after major abdominal surgery.
Methods: We studied 41 patients prospectively. This was a prospective cohort study. The patients, after ethics committee approval, who were planned to have major abdominal surgery, aged between 35 and 75, were included to the study. 37 patients’ data were included to the study; because two patients were excluded because of motor block developed during research, and 2 patients were excluded because catheter tips were migrated from the epidural space. Epidural catheters were applied to all patients, at proper levels for the surgery, preoperatively. In the first group; bupivacaine infusion was administered postoperatively, via patient controlled analgesia (PCA) machine. In the second group 25 mg bupivacaine bolus was administered before surgery and bupivacaine infusion via PCA was administered at the postoperative period. In the third group 25 mg bupivacaine bolus was administered preoperatively and bupivacaine infusion was administered intra and postoperatively via PCA. Pain levels of the patients were evaluated by using numeric rating scale (NRS). In NRS, patients were asked to evaluate their pain levels between 0 to 10, as 0; no pain and 10 is the worst pain ever.
Results: In all groups postoperative NRS levels were below 4, and sufficient postoperative analgesia was provided. In the third group significant lower analgesia scores and lower intraoperative analgesic consumptions were achieved (P<0.05). In this group arterial blood pressures were lower than the other groups, but they were not lower than the physiologic limits.
Conclusion: Epidural bupivacaine administration is a safe and effective method for postoperative pain management for patients who will have major abdominal surgery.
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