The effect of low-dose bupivacaine on postoperative epidural fentanyl analgesia and thrombelastography
| Autor: | Leonard D. Wade, Cynthia A. Wong, Honorio T. Benzon, Cindy Brooke, Hak Y. Wong |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual analogue scale medicine.drug_class medicine.medical_treatment Sedation Fentanyl Double-Blind Method medicine Humans Saline Aged Bupivacaine Pain Postoperative medicine.diagnostic_test business.industry Local anesthetic Middle Aged Thromboelastography Surgery Thrombelastography Analgesia Epidural Anesthesiology and Pain Medicine Anesthesia Vomiting Female medicine.symptom business medicine.drug |
| Zdroj: | Anesthesia and analgesia. 79(5) |
| ISSN: | 0003-2999 |
| Popis: | We performed a prospective, randomized, double-blind study to determine the effect of bupivacaine on postoperative epidural fentanyl analgesia and thrombelastography in 120 patients who underwent extensive gastrointestinal or genitourinary surgery. The patients were randomized into four groups, 30 patients per group: Group I = epidural fentanyl (EF), 10 micrograms/mL in saline; Group II = EF with 0.1% bupivacaine; Group III = EF with 0.15% bupivacaine; and Group IV = EF with 0.2% bupivacaine. Pain relief was evaluated by a visual analog scale (VAS), both at rest and during coughing, and by a visual rating scale (VRS). The VAS, VRS, degree of sedation, and side effects (nausea, vomiting, and pruritus) were evaluated every 2 h from 8:00 AM to 6:00 PM, for 24 h after surgery. Forced vital capacities (FVCs) were determined before surgery and at 24 h after surgery. Blood was withdrawn for thrombelastography (TEG) measurements preoperatively, in the recovery room (PARR), and 24 h postoperatively. The VAS, VRS, sedation scores, changes in postoperative FVCs, and the incidence of side effects were not statistically different among the four groups. The 24-h total volumes of infusion in the four groups (146 +/- 40 mL, 140 +/- 38 mL, 142 +/- 40 mL, 124 +/- 21 mL, respectively) were not statistically different from each other. There were no significant differences in the TEG values [reaction time (R), coagulation time (K), angle (alpha), and maximum amplitude (mA)] among the four groups at anytime nor was there any difference between the baseline, PARR, and 24-h TEG values within any group.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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