Interpleural bupivacaine infusion compared with intravenous pethidine infusion after cholecystectomy.
Twenty-six cholecystectomy patients received either an interpleural infusion of bupivacaine (Group B, n = 12) or an intravenous infusion of pethidine (Group P, n = 14) for management of postoperative pain over a three-day period. Patients in Group P experienced a significantly (P less than 0.05) greater incidence of total side-effects (146) than patients in Group B (66). Pain scores (VAS) and responses to a pain questionnaire were similar for both groups; however, within Group B improvement in mean VAS scores at rest with time were more sustained. Similar reductions in FEV1 and FVC from preoperative values occurred for both groups, while for Group P there were significant (P less than 0.05) changes in arterial blood gases (increase in PCO2, decrease in PO2) over two days postoperatively. Patients in Group P recorded longer times to passing flatus and unaided mobilisation (P less than 0.05), and required a significantly greater number of additional medications (anti-emetics and analgesics) over the postoperative period (41 vs 29, P less than 0.05).
Kastrissios
H
H
Department of Pharmacy, University of Queensland, Brisbane.
Mogg
G A
GA
Triggs
E J
EJ
Higbie
J W
JW
D000328:Adult; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D002245:Carbon Dioxide / Q000097:blood; D002763:Cholecystectomy; D003371:Cough / Q000503:physiopathology; D005260:Female; D005414:Flatulence / Q000503:physiopathology; D005541:Forced Expiratory Volume; D006801:Humans; D007262:Infusions, Intravenous; D007267:Injections; D007273:Injections, Intramuscular; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010994:Pleura; D012146:Rest; D013997:Time Factors; D014797:Vital Capacity
D002245:Carbon Dioxide; D008614:Meperidine; D002045:Bupivacaine