Postoperative Pain
Conditions
Keywords
epidural analgesia, pain score, morphine, transversus abdominis plane block, wound infiltration
Brief summary
The aim of our study was to compare the effects of Lomber Epidural Analgesia (LEA), Transversus Abdominis Plane (TAP) block and Local Anesthetic Infiltration (LAI) on postoperative morphine consumption, time to first recue analgesic request, pain and patient satisfaction scores and side effects were compared in the patients undergoing major gynecologic/oncology lower abdominal surgery.
Detailed description
Following faculty ethical committee approval and written informed consent, 81 patients were included in our prospective, randomized and double-blind study. Patients were divided into 3 groups: lumbar epidural block (Group E), TAP block (Group T), and wound infiltration (Group I). Demographic data, surgical characteristics, hemodynamic values, pain scores at rest and on movement, morphine consumption, additional analgesic requirement, side effects at 1, 2, 6, 12, 24, 36 and 48th hours after surgery, and patient satisfaction scores at 24 and 48th hours were recorded.
Interventions
PROCEDURElumbar epidural analgesia with bupivacaine
postoperative analgesic method
PROCEDUREtransversus abdominis plane block with bupivacaine
postoperative analgesic method
PROCEDUREwound infiltration with bupivacaine
postoperative analgesic method
Sponsors
Cukurova University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 69 Years
Healthy volunteers
Yes
Inclusion criteria
* ASA I-II, * between the age of 18-69, * undergoing major gynecological abdominal surgery under general anesthesia
Exclusion criteria
* lack of patient consent * ASA \> III * sensitivity or contraindication to study drugs * conditions in which epidural anesthesia is contraindicated * emergency and urgent surgery * inability to comprehend pain scale * any contraindication to the use of patient controlled analgesia (PCA) device.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| morphine consumption | change from baseline morphine comsumption at 48 hours | At the end of the surgery, the patients were allowed to use the patient controlled analgesia device (PCA). The PCA (CADD Legacy PCA pump, Smiths Medical MD, Inc. St. Paul, MN) was prepared with 40 mg morphine HCl in 100 ml saline. The PCA doses of morphine consisted of a bolus dose of 0.02 mg/kg every 15 minutes without a background infusion. Morphine consumption (mg) was evaluated and recorded postoperative 48 hours. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pain scores | change from baseline pain scores at 48 hours | postoperative pain scores of the patients were recorded using visual analog scale (VAS; 0=no pain, 10=worst pain) |
| patient satisfaction score | postoperative 24 and 48 hours | patient satisfaction scores were recorded using patient satisfaction scale (0= worst, 10=excellent) |
| time to first rescue analgesic | postoperative 48 hours | If the patients complained of pain despite the analgesia regimen, iv 50 mg meperidine was given as a rescue analgesic. |
| side effects | postoperative 48 hours | all patients were visited after surgery in the ward and side effects were evaluated and recorded |
Countries
Turkey (Türkiye)
Outcome results
None listed