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Changes in pulmonary function during continuous epidural bupivacaine with or without morphine following upper
S Sakura1, T Yanagidani, Y Saito
1Department of Anesthesiology, Shimane Medical University, Izumo, Japan.
Journal of Anesthesia
|October 1, 1990
Summary
Continuous thoracic epidural infusion of bupivacaine with or without morphine effectively manages pain after upper abdominal surgery. Both methods improved pulmonary function, with the combination offering superior pain relief at 40 hours post-operation.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Postoperative pain following upper abdominal surgery (UAS) can impair pulmonary function.
- Continuous thoracic epidural infusion is a common method for managing postoperative pain.
Purpose of the Study:
- To evaluate the impact of continuous thoracic epidural infusion of bupivacaine, with or without morphine, on pulmonary function and pain control in patients undergoing UAS.
Main Methods:
- A prospective randomized study involving 16 patients undergoing UAS.
- Two groups received continuous epidural infusions: bupivacaine alone or bupivacaine-morphine combination.
- Pulmonary function (PaO2, FRC, TV) and pain scores were measured at multiple postoperative time points.
Main Results:
- Both groups experienced a significant 15-25% decline in PaO2, FRC, and TV postoperatively compared to preoperative values.
- No significant differences in pulmonary function were observed between the bupivacaine and bupivacaine-morphine groups.
- The bupivacaine-morphine combination group reported significantly less pain at 40 hours postoperatively.
Conclusions:
- Continuous thoracic epidural infusion of bupivacaine and morphine is highly effective for pain alleviation in UAS patients.
- This method also improves postoperative pulmonary function, comparable to bupivacaine alone.
- The combination therapy offers enhanced analgesia at later postoperative stages.