Continuous epidural infusion of ropivacaine for postoperative analgesia after major abdominal surgery: comparative study with i.v. PCA morphine

Br J Anaesth. 1998 Dec;81(6):887-92. doi: 10.1093/bja/81.6.887.

Abstract

We have compared the quality of three regimens of postoperative analgesia (continuous epidural administration of ropivacaine (Ropi. group), epidural ropivacaine and patient-controlled analgesia (PCA) with i.v. morphine (Ropi. + PCA group) and PCA morphine alone (PCA group)) during the first postoperative 24 h in a multicentre, randomized, prospective study. Postoperative analgesia was studied in 130 patients after major abdominal surgery performed under general anaesthesia. The ropivacaine groups received 20 ml of epidural bolus ropivacaine 2 mg ml-1 via the epidural route at the end of surgery, followed by continuous infusion of 10 ml h-1 for 24 h. The Ropi. + PCA group also had access to i.v. PCA morphine 1 mg, with a 5-min lockout. The PCA group received morphine as the sole postoperative pain treatment. The two ropivacaine groups had lower pain scores (P < 0.01) than the PCA group. Morphine consumption was higher in the PCA group (P < 0.05) than in the two ropivacaine groups. The quality of pain relief was rated as good or excellent in 79-85% of patients in the three groups. The percentage of patients without motor block increased between 4 and 24 h from 61% to 89% in the Ropi. group, and from 51% to 71% in the Ropi. + PCA group.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / surgery*
  • Adolescent
  • Adult
  • Aged
  • Amides / administration & dosage*
  • Analgesia, Epidural / methods*
  • Analgesia, Patient-Controlled
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Local / administration & dosage*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Ropivacaine

Substances

  • Amides
  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Ropivacaine