Abstract
The effect of postoperative continuous epidural analgesia on pulmonary function was assessed after upper abdominal surgery and compared to conventional analgesia. 21 patients were randomly assigned to one of three treatment groups: (1) a parenteral analgesic, antagonistic agonist, (2) continuous epidural infusion of morphine, (3) continuous epidural infusion of a combination of morphine and bupivacaine. The study continued for the first 72 postoperative hours. Analgesia was tested on Prince Henry pain scale and a visual pain scale. Pulmonary function was evaluated by BGA, FVL and spirometry. Measurements were performed on the day before the operation and at 24, 48, 72 postoperative hours. Pain scoring showed better analgesia in the two epidural groups during the postoperative period. No significant differences occurred in PaO2 between the conventional group and the continuous epidural morphine group. The combination group was able significantly to improve PaO2, FRC and FEV1.0 better than the conventional group. The authors conclude that continuous epidural infusion of a solution combining morphine and bupivacaine is highly effective in alleviating pain and improving respiratory function in patients after upper abdominal surgery.
