title: Postoperative analgesia for oesophageal surgery: a comparison of three analgesic regimens.
abstract: Sixty-four patients undergoing oesophageal surgery were randomly allocated to receive either a continuous lumbar epidural infusion of morphine or fentanyl, or, intramuscular morphine for postoperative analgesia. There was no statistical difference in analgesic requirements between the patients who underwent a thoracotomy for their procedure (n = 50) and those who did not (n = 14), as assessed by the total dose of opioid administered, visual analogue scale (VAS) and pain score (PS) comparison. However, by these criteria, epidural morphine infusion provided the most satisfactory analgesia (P less than 0.05). Despite the variable quality of analgesia achieved with the three regimens, the postoperative lung function tests were similar for all groups, and we conclude that routine lung function tests are not an appropriate method of comparing analgesic efficacy. Prophylactic administration of loratadine to 15% of our patients was not shown to be effective in diminishing the incidence of pruritus.
authors.affiliation: Government Anaesthetic Unit, Queen Mary Hospital, Hong Kong.
authors.forename: S L
authors.initials: SL
authors.lastname: Tsui
authors.forename: C S
authors.initials: CS
authors.lastname: Chan
authors.forename: A S
authors.initials: AS
authors.lastname: Chan
authors.forename: S J
authors.initials: SJ
authors.lastname: Wong
authors.forename: C S
authors.initials: CS
authors.lastname: Lam
authors.forename: R D
authors.initials: RD
authors.lastname: Jones
mesh_terms: D000328:Adult; D000698:Analgesia; D015360:Analgesia, Epidural; D003243:Consciousness / Q000187:drug effects; D016629:Esophagectomy; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007273:Injections, Intramuscular; D007813:Laparotomy; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care; D012119:Respiration / Q000187:drug effects; D013908:Thoracotomy
chemical_list: D009020:Morphine; D005283:Fentanyl