Document Detail


Epidural bupivacaine and morphine plus systemic indomethacin eliminates pain but not systemic response and convalescence after cholecystectomy.
MedLine Citation:
PMID:  3344486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied 24 patients undergoing elective cholecystectomy and randomized to either conventional postoperative pain treatment, with intermittent nicomorphine (10 to 15 mg) and acetaminophen (1 gm) on request, or thoracic epidural analgesia with plain bupivacaine for 48 hours and epidural morphine 4 mg every 8 hours for 96 hours plus systemic indomethacin 100 mg every 8 hours for 96 hours. Epidural analgesia for pin prick extended from the fourth thoracic to the first lumbar nerve for 48 hours. Assessments of pain, various injury response parameters, peak flow, and subjective feeling of fatigue were performed preoperatively, 3 and 6 hours after skin incision, and 1, 2, 4, and 8 days postoperatively. The epidural analgesia-systemic indomethacin treatment eliminated postoperative pain during rest and coughing. In contrast, only a minor and clinically unimportant modulation of the conventional perioperative and postoperative changes in plasma cortisol, glucose, transferrin, orosomucoid, leukocyte and differential counts, rectal temperature, peak flow, and fatigue was observed. Our results suggest that factors other than pain per se must be controlled in order to reduce postoperative morbidity.
Authors:
S Schulze; O Roikjaer; L Hasselstrøm; N H Jensen; H Kehlet
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Surgery     Volume:  103     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1988 Mar 
Date Detail:
Created Date:  1988-04-01     Completed Date:  1988-04-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  321-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgical Gastroenterology and Anesthesiology, Herlev University Hospital, Copenhagen, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Cells
Blood Chemical Analysis
Bupivacaine / administration & dosage*
Cholecystectomy*
Convalescence
Drug Therapy, Combination
Female
Humans
Indomethacin / administration & dosage*
Injections, Epidural
Male
Middle Aged
Morphine / administration & dosage*
Pain, Postoperative / drug therapy*
Random Allocation
Chemical
Reg. No./Substance:
2180-92-9/Bupivacaine; 53-86-1/Indomethacin; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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