ABSTRACT
Postoperative pain is a potent trigger for the stress response, activates the autonomic system, and is thought to be an indirect cause of adverse effects on various organ system. Postoperative epidural analgesia can significantly decrease the incidence of pulmonary morbidity and is often considered the most effective technique for providing pain relief after abdominal surgery. The present study was carried on 60 patients ASA I-III were classified into 3 equal groups according to the epidurally infused solution, Group S received 10ml/h of sufentanil 5 micro g, Group BS received 10 ml/h of sufentanil 0.5?g/ml with 0.25% bupivacaine and Group RS received 10 ml/h of sufentanil 0.5 micro g/ml with 0.2% ropivacaine for postoperative analgesia after upper abdominal surgery through thoracic epidural catheter to compare and assess the quality of analgesia, the safety and the side-effects after the use of a continuous, thoracic epidural infusion for postoperative analgesia in patients who had undergone major upper abdominal surgery. The results showed that highly significant decrease in visual analogue scale [VAS] in all groups over a time with high pain scores in group S than in BS and RS groups. There were insignificant changes between groups as regarding homodynamic and side effects except for a decrease in mean arterial pressure of over time in-group BS and high incidence of motor block in-group BS than the other two groups. This study showed that a continuous, thoracic epidural infusion of sufentanil 5 micro g/h provided adequate and safe pain relief after major upper abdominal surgery. The quality of analgesia was further improved when a mixture of bupivacaine or ropivacaine with sufentanil was adminstered. The combination of 0.2% ropivacaine plus sufentanil 5 micro g/h appeared preferable because of the low incidence of motor block and hypotension when compared with 0.25% bupivacaine plus sufentanil 5 micro g/h