title: Comparison of effects of epidural bupivacaine and intravenous meperidine analgesia on patient recovery following elective abdominal aortic surgery.
abstract: BACKGROUND
  The efficacy of epidural anesthesia and analgesia in management of perioperative stress has been established. Perioperative pain management strategies decrease surgical complications and aid recovery. In this study, we aimed to document and compare the efficacy of epidural bupivacaine and intravenous meperidine on recovery of patients with elective abdominal aortic surgery performed under general anesthesia.
  
  
  METHODS
  Patients undergoing elective abdominal aortic surgery between February 2009 and November 2011 were studied prospectively. Patients were randomized into epidural bupivacaine (n=40) and intravenous meperidine (n=40) groups regarding postoperative analgesia strategy. The preoperative demographic characteristics, perioperative outcomes, postoperative adverse effects of analgesia strategy, time to initiate oral intake, sedation scores, visual analogue scale results, and mobility scores were compared.
  
  
  RESULTS
  The mean ages of the patients were 61.7±8.1 in the epidural group and 59.4±9.7 in the intravenous group (p>0.05). The preoperative demographic characteristics of the patients were comparable between the groups. There were no statistically significant differences between groups regarding anesthesia times, intubation times, intensive care unit stay, hospital length of stay, postoperative vomiting, and postoperative cardiac, renal, and cerebral complications. Postoperative nausea was more prevalent in the meperidine group (p<0.05). In the epidural group, time to begin oral intake was shorter, sedation scores and visual analogue scale results were lower, and mobility scores were higher (p<0.05 each).
  
  
  CONCLUSIONS
  Epidural analgesia allowed earlier recovery compared to intravenous analgesia in patients undergoing elective abdominal aortic surgery, but did not affect postoperative outcomes and complications.
authors.affiliation: Department of Anesthesia, Medicana International Ankara Hospital, Ankara, Turkey.
authors.forename: Nevriye
authors.initials: N
authors.lastname: Salman
authors.forename: Ahmet Baris
authors.initials: AB
authors.lastname: Durukan
authors.forename: Hasan Alper
authors.initials: HA
authors.lastname: Gurbuz
authors.forename: Hasan
authors.initials: H
authors.lastname: Yamalı
authors.forename: Leyla
authors.initials: L
authors.lastname: Guler
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Ucar
authors.forename: Cem
authors.initials: C
authors.lastname: Yorgancioglu
mesh_terms: D015360:Analgesia, Epidural; D001012:Aorta, Abdominal / Q000601:surgery*; D002045:Bupivacaine / Q000008:administration & dosage / Q000494:pharmacology*; D003710:Demography; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D019990:Perioperative Care; D020127:Recovery of Function / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D008614:Meperidine; D002045:Bupivacaine