title: Continuous epidural infusion for postoperative pain relief: a comparison of three regimens.
abstract: We evaluated the postoperative pain relief and side-effects of continuous epidural infusion of three analgesic regimens following major thoracic and/or abdominal surgery. One hundred and twenty patients were randomly divided into three treatment groups: (1) 0.25% or 0.5% bupivacaine at a rate of 3-7 ml.hr(-1), (2) 0.01% morphine at a rate of 1-2 ml.hr(-1), (3) a combination of 0.125% or 0.25% bupivacaine and 0.0025% or 0.005% morphine at a rate of 2-4 ml.hr(-1). The study continued for the first 48 postoperative hours. The effect of pain relief was evaluated by assessment of the further requirement for parenteral analgesics. Sixty-four percent of the patients given bupivacaine, 56% of the patients given morphine and 80% of the patients given the combination required no supplemental analgesics. Continuous epidural infusion of bupivacaine was associated with hypotension (21%) and with numbness and weakness of hands or legs (18%). Continuous epidural infusion of morphine was associated with pruritus (18%) and with peristaltic depression (12%). The combination regimen was associated with pruritus (17%) and with drowsiness (14%). We conclude that the combination of bupivacaine and morphine significantly provides superior analgesia with less deleterious complications compared with either bupivacaine or morphine alone.
authors.affiliation: Department of Anesthesiology, Shimane Medical University, Izumo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Sakura
authors.forename: H
authors.initials: H
authors.lastname: Uchida
authors.forename: Y
authors.initials: Y
authors.lastname: Saito
authors.forename: M
authors.initials: M
authors.lastname: Asano
authors.forename: Y
authors.initials: Y
authors.lastname: Kosaka