Background & Aims
Epidural analgesia is very useful in the postoperative pain management following epidural surgeries. This prospective, double-blind, randomized trial was done to evaluate the optimal dose of background infusion in the management of post-operative pain in patients undergoing abdominal surgery.
Methods
Fifty patients undergoing lower abdominal surgery under general anaesthesia and thoracic epidural analgesia (T8-9 or T9-10 interspace) were randomly allocated into two groups; Group 1: 50% of the hourly epidural dose (0.1ml/kg) in the form of background infusion (remaining 50% as demand dose); Group 2: 25% of the hourly epidural dose (0.1ml/kg) in the form of background infusion (remaining 75% as demand dose). Primary outcome measure was numerical rating scale (NRS) scores during coughing, and secondary outcome measures were postoperative nausea and vomiting (PONV), requirement of rescue analgesia and rescue antiemetic, hypotension, motor block, sedation, pruritis and respiratory depression; patients were assessed till the morning of third post-operative day.
Results
Post-operative NRS score for dynamic pain was found to be lower in Group 1 than that of Group 2. Post-operative epidural ropivacaine consumption was significantly lower in the Group 1 with 50% background infusion as compared to Group 2 with 25% background infusion (P < 0.05). The incidence of sedation, hypotension, motor block, severity of PONV and requirement of anti-emetic were comparable in the two groups.
Conclusions
Thoracic epidural administration of ropivacaine-fentanyl solution with 50% hourly epidural infusion dose in form of background infusion provides better pain relief as compared to 25% hourly epidural infusion after major abdominal surgery.
References
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Presenting Author
Sujeet Kumar Singh Gautam
Poster Authors
Sujeet Kumar Singh Gautam
MD
Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow
Lead Author
Jyotsana Jaiswal
MD
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow
Lead Author
Sandeep Khuba
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow
Lead Author
Anil Agarwal
Sanjay Gandhi Post Graduate Institute of Medical Sciences
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Acute Pain and Nociceptive Pain