Evaluation of the addition of bupivacaine to intrathecal morphine for intraoperative and postoperative pain management in open liver resections
Autor: | Hung-Mo Lin, Amir K. Abdel-Kader, Andrew M Glasgow, John Foote, Diana N Romano |
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Rok vydání: | 2022 |
Předmět: |
Analgesic
Intrathecal morphine Fentanyl 03 medical and health sciences 0302 clinical medicine Humans Medicine Prospective Studies Anesthetics Local Retrospective Studies Bupivacaine Pain Postoperative Morphine Hepatology business.industry Gastroenterology Retrospective cohort study Analgesics Opioid Liver 030220 oncology & carcinogenesis Anesthesia Defecation 030211 gastroenterology & hepatology Intraoperative Period business medicine.drug |
Zdroj: | HPB. 24:202-208 |
ISSN: | 1365-182X |
Popis: | Background Intrathecal morphine is a popular and effective regional technique for pain control after open liver resection, but its delayed analgesic onset makes it less useful for the intraoperative period. The aim of this retrospective study was to compare the analgesic efficacy and other secondary benefits of the addition of hyperbaric bupivacaine to intrathecal morphine ± fentanyl. We hypothesized that bupivacaine could serve as an analgesic “bridge” prior to the onset of intrathecal morphine/fentanyl thereby lowering opioid consumption and enhancing recovery. Methods Cumulative intraoperative and postoperative opioid consumption as well as other intra- and postoperative variables were collected and compared between groups receiving intrathecal morphine alone or intrathecal morphine ± hyperbaric bupivacaine. Results Sixty-eight patients were selected for inclusion. Cumulative intraoperative morphine consumption was significantly reduced in the bupivacaine group while other intraoperative parameters such as intravenous fluids, blood loss, and vasopressors did not differ. There was a statistically significant improvement in time to first bowel movement in the experimental group. Discussion The intraoperative opioid sparing effects and improved time to bowel function with the addition of hyperbaric bupivacaine to intrathecal morphine may make this technique an easy and low risk method of enhancing recovery after open liver resection. |
Databáze: | OpenAIRE |
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