Naslov
Continuous wound infusion of levobupivacaine after total abdominal hysterectomy with bilateral salpingo-oophorectomy

Autori
Marić, Stela ; Banović, Miroslav ; Šakić Zdravčević, Kata ; Štefančić, Ljiljana ; Bartolek, Dubravka

Izvornik
Perodicum Biologorum (0031-5362) 111 (2009), 2; 299-302

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
continuous wound infusion analgesia; levobupivacaine: opioid analgesia; morphine; hysterectomy

Sažetak
Blockade of nociceptive afferents by the use of continuous wound infiltration with local anesthetics may be beneficial in a postoperative multimodal pain management after total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO). The role of continuous wound infusion of levobupivacaine for pain relief and postoperative recovery was evaluated. Fifty female patients (ASA I-III) scheduled for TAH and BSO were divided in two equal groups during prospective, double-blinded, placebo-controlled trial. On completion of the operation, a multiorifice 20-gauge epidural catheter was placed above the superficial abdominal fascia. Patients were randomly assigned to receive through the catheter 0.25% levobupivacaine (Group L) with 6ml bolus followed by an infusion of 7 ml/h during 48 h, or the same protocol with 0.9% NaCl (Group S). Simultaneously, patient-controlled analgesia provided intravenous morphine. All patients also received diclofenac 75 mg every 12 h for 48 h. Median Visual Analogue Scale (VAS) was satisfactory. Compared with suprafascial saline, levobupivacaine infusion reduced morphine consumption during the first 48 h. The morphine consumption was significantly less (P<0.001) in Group L (6.91 +/– 3.17 mg) in comparison to Group S (50.61 +/– 14.02 mg). Nausea was less in Group L. Time to recover the bowel function was significantly reduced in Group L. No side effects were observed. Postoperative pain control with continuous wound infusion of 0.25% levobupivacaine after TAH with BSO provides effective analgesia, decreases opioid requirements and reduces time to recover the bowel function.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA