Analgesic Effect of Epidural Morphine and Incisional Site Infiltration with Bupivacaine in the Lower Abdominal Surgery / 대한마취과학회지

ABSTRACT

IIn a randomized double-blind study, postoperative pain was assessed in 60 patients undergoing gynecologic surgery with three types of anesthesia; inhalation anesthesia only (enflurane-N2O-O2-vecuronium)(G); inhalation anesthesia with local infiltration (infiltration of the abdominal wall with 40 ml 0.25% bupivacaine along the line of the proposed incision)(GI); and inhalation anesthesia with epidural analgesia (morphine 2 mg mixed with 10 ml 0.125% bupivacaine)(GE). The severity of constant incisional pain, movement-associated incisional pain, and pain upon pressure applied to the surgical wound using 5 pounds of weight was assessed with a visual analogue scale at 2, 6, 12, 24, and 48 hours after surgery. The duration of analgesia (time from the end of the surgery to the first request for analgesic) was 7.9+/-3.1 hours in group G, 22.8+/-4.8 hours in group GI, and 33.1+/-3.9 hours in group GE, with statistically significant differences between group G and other two groups. Forced vital capacity (FVC), peak expiratory flow, and forced expiratory volume in 1 second (FEV1) were measured with the patients in a semisitting position. In all groups, there were no differences in above parameters, These results indicate that postoperative pain after lower aMominal surgery would be managed satisfactorily with infiltration of local anesthetic as well as epidural analgesia.