Open AccessAudit of Intrathecal, Epidural and Intravenous Analgesia for Abdominal Surgery
Author(s) -
Savage Joyce,
Duncan Michael
Publication year - 2006
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2006.00208_6.x
Subject(s) - medicine , anesthesia , midazolam , fentanyl , bupivacaine , morphine , intrathecal , abdominal surgery , analgesic , ketamine , surgery , sedation
Background: Many studies have compared epidural and intravenous postoperative analgesia. To date there are no studies comparing intrathecal with epidural and intravenous regimes. Aim: To audit standard postoperative intrathecal (incorporating midazolam), epidural and systemic intravenous analgesic regimes used at Monash Medical Centre. Method: This was a prospective nonblinded study conducted over 9 months. Data was collated for 15 patients of each of the following regimes, identified through the Acute Pain Service.• Intrathecal infusion of Morphine 10 mcg + Midazolam 100 mcg + Bupivacaine 0.5 mg per ml at 1–2 ml/hr • Epidural infusion of Fentanyl 2 mcg/ml + Bupivacaine 1.25 mg/ml at 6–12 ml/hr • Intravenous Morphine Patient Controlled Analgesia 1 mg boluses + /− background infusion and Ketamine infusion at 0.1–0.2 mg/kg/hrInclusion criteria were: patients conversant in English and over 60 years of age, having open abdominal surgery and postoperative ventilation less than 24 hours. Results: Statistical data analysis showed a significant difference between the groups in the median number of calls to the pain service: Data on pain scores, postoperative haemodynamic stability and pyrexias were also notable: Conclusions: The intrathecal group trends towards better postoperative analgesia and less intervention required compared to epidural or intravenous regimes.