title: Addition of 0.1% bupivacaine to buprenorphine and droperidol in patient-controlled epidural analgesia improved postoperative pain scores on coughing after gynecological surgery.
abstract: OBJECTIVE
  To compare the analgesic efficacy of additional 0.1% bupivacaine to patient-controlled epidural analgesia (PCEA) using buprenorphine and droperidol after gynecological surgery.
  
  
  METHODS
  Randomized, double-blinded study.
  
  
  METHODS
  Operating theater and general ward at Jichi Medical School Hospital.
  
  
  METHODS
  Thirty patients with American Society of Anesthesiologists physical status I and II scheduled for gynecological surgery.
  
  
  METHODS
  Patients received combined general and epidural anesthesia for surgery and epidural analgesia for postoperative analgesia. Patients were assigned to receive PCEA with or without 0.1% bupivacaine. Group 1 (n = 15) received buprenorphine 20 microg and droperidol 0.1 mg diluted with saline, and group 2 (n = 15) received bupivacaine 2 mg, buprenorphine 20 microg, and droperidol 0.1 mg diluted with saline (0.1% bupivacaine solution) in a bolus dose of the PCEA, respectively. No background epidural infusion was used.
  
  
  METHODS
  Visual analog pain scale (VAPS) scores at rest and on coughing, and cumulative frequency of self-administrated analgesic solution in PCEA were recorded at 24 and 48 hours postoperatively.
  
  
  RESULTS
  There were no significant differences noted between the groups in VAPS scores at rest or in cumulative volumes of PCEA solution in 24 or 48 hours postoperatively. Median VAPS scores on coughing in group 2 were significantly lower than those values in group 1 at 24 hours (36 vs 65 mm, P < .001) and 48 hours (32 vs 54 mm, P = .036) postoperatively.
  
  
  CONCLUSIONS
  Addition of 0.1% bupivacaine to PCEA using buprenorphine and droperidol provides better analgesia on coughing after gynecological surgery.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Jichi Medical School, Tochigi 329-0498, Japan. inoues@jichi.ac.jp
authors.forename: Soichiro
authors.initials: S
authors.lastname: Inoue
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Mitsuhata
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kawakami
authors.forename: Keiko
authors.initials: K
authors.lastname: Shimohata
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hirabayashi
authors.forename: Norimasa
authors.initials: N
authors.lastname: Seo
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D002045:Bupivacaine / Q000627:therapeutic use*; D002047:Buprenorphine / Q000627:therapeutic use; D002491:Central Nervous System Agents / Q000627:therapeutic use*; D003371:Cough / Q000150:complications; D004311:Double-Blind Method; D004329:Droperidol / Q000627:therapeutic use; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D002491:Central Nervous System Agents; D002047:Buprenorphine; D004329:Droperidol; D002045:Bupivacaine