Key result
Epidural analgesia with morphine plus bupivacaine resulted in effective peristalsis within 6 hours for all patients (vs after 30 hours) and reduced pneumonia (6.7% vs 33.3%, p<0.05).
Why the study?
Does epidural morphine plus bupivacaine improve postoperative intestinal motility and reduce complications compared to morphine alone in patients undergoing major hepatobiliary surgery?
Population
60 patients with a mean age of 61.2 years and an ASA score of 2 or 3, all with hepato-biliary-pancreatic…
Comparison
Thoracic epidural analgesia with morphine 0.0017… vs Thoracic epidural analgesia with morphine alone…
Design
RCT, Prospective randomised study
Follow-up
Postoperative period (up to 5 days reported)
Authors
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Supports combined epidural analgesia for enhanced recovery after HPB surgery; extends abdominal surgery evidence to this population.
RCT (n=60)
Does epidural morphine plus bupivacaine improve postoperative intestinal motility and reduce complications compared to morphine alone in patients undergoing major hepatobiliary surgery?
Absolute Event Rate: 100% vs 0%
Epidural analgesia with morphine plus bupivacaine allows a more rapid return to normal gut activity and early enteral nutrition compared to morphine alone after major hepatobiliary surgery.
Barzoi et al. (1998) conducted an RCT in Hepato-biliary-pancreatic neoplasm (n=60). Morphine plus bupivacaine epidural analgesia vs. Morphine alone epidural analgesia was evaluated on Effective peristalsis within the first six postoperative hours. Epidural analgesia with morphine plus bupivacaine resulted in effective peristalsis within 6 hours for all patients (vs after 30 hours) and reduced pneumonia (6.7% vs 33.3%, p<0.05).
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