Naslov
Benefit after continous epidural analgesia after pelvic fracture in trauma patients with low cardiac index

Autori
Bartolek, Dubravka

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstract of the XXVIII Annual ESRA Congres of Europen Sociaty of Regional Anaesthesia & Pain ; u Regional Anesthesia and Pain Medicine (2009)34(5) ; 1-192.(doi10.1097/AAP.0b013e3181b968fc) / - , 2009, 1-192

Skup
Annual ESRA Congress of Europen Sociaty of Regional Anaesthesia & Pain (28 ; 2009)

Mjesto i datum
Salzburg, Austrija, 09.09.2009. - 12.09.2009

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
pelvic trauma; epidural analgesia

Sažetak
Eldery trauma patient with low cardiac index (CI) are haemodynamic very sensitive on parenteral opioid analgetic therapy what often result with inotrope drug use. Continous epidural analgesia improves excellent pain control in patients with multiple pelvic fractures. The aim was to detect the influence of continous epidural analgesia on hemodinamic suport by patients with low CI after several pelvic fracture. Sixty trauma patients with multiple pelvic fractures were divided in two equal groups and included in prospective, randomized study during one year period. In bought groups initial analgesia was started with sufentanil 10 ucg/h in the first 24h. In Group EP continous epidural analgesia (levibupivacain O.125%, 5-7 ml/h) was started after 24h. In Group O continous infusion of opioid (sufentanil 5-10 ucg/h) was followed. The titration dose of analgetics in the bought groups following the VAS score under 3. PICCO monitoring was establisch in all patients. MAP, CI, heart rate, SVRI, ITBWI and ETBWI was measured during five days. The study groups were comparabile in demographic data. Under first 24 hours in bought groups were the high need for fluid replacement (ETBWI less than 10). In Group EP SVRI was less (800-1000) after epididural analgesia and recovered with 500-750 ml of kristaloids. ITBWI was stastistical more stable in Group EP (850) to compare Group O (950-1000). 48% patient in Group EP and 72% in Group O need inotrpe support (P<0.05). Continous epidural analgesia with 0.125% levibupivacain improves better haemodinamic stability in patient with low CI after pelvic fracture and reduced the need for inotope suport more than continous opioid analgesia.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA