Abstract
This study was undertaken to determine whether short-term continuous epidural analgesia using morphine would relieve pain after laparoscopic cholecystectomy. The authors retrospectively reviewed the clinical data of 182 cases who had undergone a laparoscopic cholecystectomy. These cases were divided into four groups according to their anesthetic modes as follows: a control group with general anesthesia only (n=37); group I, general anesthesia combined with one shot of epidural morphine (n=78); and group II, general anesthesia combined with continuous epidural analgesia using morphine (IIa for 12 h (n=33); IIb for 8 h (n=34)). The pain score on a four-category verbal scale and the frequency of analgesic use were investigated. There were no differences in the background characteristics of the patients among the groups, except for the duration of surgery (Ivs IIa;P=0.006). The pain scores were significantly different between the control group and the other groups. The frequency of analgesic use in the control group was also significantly higher than in the other groups. A tendency toward a higher frequency of analgesic use in group I, compared with that in groups IIa and IIb, was observed. These findings thus suggest that short-term continuous epidural analgesia using morphine can effectively relieve postoperative pain after a laparoscopic cholecystectomy.
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References
Liu S, Carpenter RL, Neal JM (1995) Epidural anesthesia and analgesia-their role in postoperative outcome. Anesthesiology 82:1474–1506
Dahl JB, Hjortso NC, Stage JG, Hansen BL, Moiniche S, Damgaard B, Kehlet H (1994) Effects of combined perioperative epidural bupivacaine and morphine, ibuprofen, and incisional bupivacaine on postoperative pain, pulmonary, and endocrinemetabolic function after minilaparotomy cholecystectomy. Reg Anesth 19:199–205
Ohtaka K, Matsumoto S, Mitsuhata H, Yabe M (1991) The effect of continuous epidural infusion of a combination of 1% mepivacaine and buprenorphine for post-operative pain relief (in Japanese with English abstract) Masui (Jpn J Anesthesiol) 40:942–948
Matsumoto S, Hasegawa J, Mitsuhata H, Komatsu H, Mizunuma T, Matsuoka T (1992) Is a portable disposable pump useful in managing postoperative pain? (in Japanese with English abstract). Masui (Jpn J Anesthesiol) 41:638–648
Kaneko M, Saito Y, Kirihara Y, Collins JG, Kosaka Y (1994) Synergistic antinociceptive interaction after epidural coad-ministration of morphine and lidocaine in rats. Anesthesiology 80:137–150
Kehlet H, Dahl JB (1993) The value of multi-modal or balanced analgesia in postoperative pain relief. Anesth Analg 77:1048–1056
Zucker KA, Bailey RW (1993) Laparoscopic management of acute cholecystitis. In: Zucker KA (ed) Surgical laparoscopy update. Quality Medical Publishing. Missouri, USA, pp 109–143
Dubois F, Berthelot G, Levard H (1989) Cholecystectomie par coelioscopie. Presse Med 18:980–982
Dubois F, Icard P, Berthelot G, Levard H (1990) Coelioscopic cholecystectomy. Preliminary report of 36 cases. Ann Surg 211:60–62
Stoddart PA, Cooper A, Russell R, Reynolds F (1993) A comparison of epidural diamorphine with intravenous patient-controlled analgesia using the Baxter infusor following caesarean section (published erratum appears in Anesthesia 1994 49(3): 274–275). Anaesthesia 48:1086–1090
Matsumoto S, Mitsuhata H, Akiyama H, Terada H, Matsumoto H (1994) The effect of subcutaneous administration of buprenorphine with patient controlled analgesia system for postoperative pain relief (in Japanese with English abstract). Masui (Jpn J Anesthesiol) 43:1709–1713
Hanley ES (1992) Anesthesia for laparoscopic surgery. Surg Clin North Am 72:1012–1019
Barnard JM, Chaffin D, Droste S, Tierney A, Phernetton T (1995) Fetal response to carbon dioxide pneumoperitoneum in the pregnant ewe. Obstet Gynecol 85:669–674
Edelman DS (1991) Laparoscopic cholecystectomy under continuous epidural anesthesia in patients with cystic fibrosis (letter). Am J Dis Child 145:723–724
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Fujikawa, T., Nakamura, Y., Takeda, H. et al. The effect of short-term continuous epidural morphine on postoperative pain after laparoscopic cholecystectomy. Surg Today 28, 18–22 (1998). https://doi.org/10.1007/BF02483603
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DOI: https://doi.org/10.1007/BF02483603