Does Epidural Morphine Loading in Addition to Thoracic Epidural Analgesia Benefit the Postoperative Management of Morbidly Obese Patients Undergoing Open Bariatric Surgery? A Pilot Study
| Autor: | Leonidas Paridis, Kriton S. Filos, Panagiota Tagari, Anastasia Zotou, Athina Siampalioti, Fotis Kalfarentzos |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Thorax medicine.medical_specialty medicine.drug_class Endocrinology Diabetes and Metabolism Analgesic Bariatric Surgery Pilot Projects Bolus (medicine) Humans Medicine Prospective Studies Anesthetics Local Levobupivacaine Pain Measurement Pain Postoperative Nutrition and Dietetics Morphine business.industry Local anesthetic Analgesia Patient-Controlled Perioperative medicine.disease Bupivacaine Obesity Morbid Surgery Analgesia Epidural Analgesics Opioid Obstructive sleep apnea Treatment Outcome Anesthesia Female business medicine.drug |
| Zdroj: | Obesity Surgery. 24:2099-2108 |
| ISSN: | 1708-0428 0960-8923 |
| DOI: | 10.1007/s11695-014-1305-z |
| Popis: | Insufficient data exist regarding postoperative thoracic epidural analgesia for morbidly obese patients undergoing open bariatric surgery. This study evaluated the effectiveness of morphine loading in a postoperative thoracic epidural analgesic regimen of patient-controlled epidural analgesia (PCEA) with levobupivacaine combined with continuously administered epidural morphine in this patient group. In this prospective randomized controlled trial, 48 superobese patients (body mass index of ≥50 kg/m2) undergoing open bariatric surgery were randomly allocated to three groups of 16 patients each. Postoperatively, all groups received a continuous epidural morphine infusion of 0.2 mg/h with 0.1 % levobupivacaine via PCEA. Group A did not receive intraoperative epidural morphine loading, while groups B and C received an intraoperative 1- and 2-mg morphine bolus, respectively. Levobupivacaine consumption via PCEA (primary outcome), pain scores at rest and on cough, the time to return of bowel function and ambulation, and arterial blood gas levels (secondary outcomes) were recorded. The increase in perioperative morphine administration (groups B and C) led to a significantly prolonged return to normal bowel function and delayed ambulation (P |
| Databáze: | OpenAIRE |
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