Post operative analgesia with continuous epidural infusion

Area of Science:

• Anesthesiology
• Pain Management
• Pharmacology

Background:

• Post-operative pain management after major upper abdominal surgery is crucial for patient recovery.
• Epidural analgesia is a common method, but optimal drug combinations require investigation.
• Evaluating different epidural regimens can improve patient outcomes and reduce adverse events.

Purpose of the Study:

• To compare the efficacy and safety of continuous epidural infusion of morphine with bupivacaine versus monotherapy for post-operative analgesia.
• To assess pain scores using Visual Analog Scale (VAS) and Verbal Rating Scale (VRS) over 40 hours.
• To evaluate side effects such as sedation, hypotension, and neurological deficits.

Main Methods:

• Forty-eight patients undergoing major upper abdominal surgery were divided into three groups receiving different epidural infusions.
• Pain was assessed hourly for the first four hours, then at extended intervals up to 40 hours using VAS and VRS.
• Adverse events including sedation, hypotension, urinary retention, and neurological changes were monitored.

Main Results:

• All groups showed reduced pain scores within the first hour.
• Significant pain reduction was observed earlier in groups receiving combined therapy (Group II and III).
• Group III (low-dose morphine with bupivacaine) demonstrated significantly lower pain scores from 16-22 hours onwards with minimal side effects.

Conclusions:

• Continuous epidural infusion of low-dose morphine combined with bupivacaine provides superior post-operative analgesia.
• This combination therapy results in better quality pain relief with a favorable side effect profile compared to monotherapy.
• Optimized epidural regimens are essential for effective post-operative pain management in major abdominal surgery.