POST OPERATIVE ANALGESIA FOLLOWING OPEN CHOLECYSTECTOMY

IS INTERMITTENT EPIDURAL BUPIVACAIN BOLUS ADMINISTRATION MORE EFFECTIVE THAN CONTINUOUS ADMINISTRATION?

Abstract

Introduction: Pain following surgery is a universal phenomenon; it is often underestimated and undertreated. Epidural analgesia is considered to be the best method of pain relief after subcostal cholecystectomy. Epidural is effective technique that offers comparable analgesia and better side effect profile. Design: Quasi Experimental study. Period: Jan2010 to June 2010. Setting: Military Hospital Rawalpindi. Material and methods: This is a prospective, randomized control trial. The main objective of this study was to compare the number of rescue doses for postperative pain relief, after subcostal cholecystectomy under epidural anesthesia, in patients receiving continuous epidural infusion of bupivacain 0.125% with those receiving intermittent boluses. Thoracic epidural catheter was placed for post operative pain relief. Patients were divided into two equal groups. Patient receiving continuous epidural anaesthesia were placed in group A and those receiving intermittent doses were included in group B. Sampling technique: Purposive (non probability) sampling. Result: Patient who received intermittent boluses (group B) required less rescue doses of nalbuphine as compared to the patients who received continuous infusion of 0.125 bupivacain. Conclusions: Intermittent boluses of 0.125% bupivacain are considered a better method of postoperative pain relief than continuous infusion of 0.125 % bupivacain.