title: Thoracic epidural analgesia compared with patient controlled intravenous morphine after upper abdominal surgery.
abstract: Twenty-one ASA I or II patients undergoing upper abdominal surgery were studied for 24 hours after operation. They were entered into a prospective, randomised study of patient-controlled intravenous morphine compared with continuous thoracic epidural fentanyl combined with 0.2% bupivacaine. Pain relief was superior in the bupivacaine series (P < 0.05) throughout the 24 hour study period and this was associated with significantly greater pulmonary ventilation compared with the PCA series. Forced expiratory parameters were reduced in both series after the operation but significantly less so in the epidural group. There was a reduced incidence of emetic symptoms in the epidural group (P < 0.05) but the incidence of other minor side effects did not differ significantly. Thoracic epidural fentanyl/bupivacaine results in significantly better analgesia than patient-controlled intravenous morphine.
authors.affiliation: Department of Clinical Anaesthesia, Belfast City Hospital.
authors.forename: K A
authors.initials: KA
authors.lastname: George
authors.forename: P M
authors.initials: PM
authors.lastname: Wright
authors.forename: A M
authors.initials: AM
authors.lastname: Chisakuta
authors.forename: N V
authors.initials: NV
authors.lastname: Rao
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D002045:Bupivacaine / Q000009:adverse effects; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D015656:Respiratory Mechanics
chemical_list: D009020:Morphine; D005283:Fentanyl; D002045:Bupivacaine