British Journal of Anaesthesia, Vol 81, Issue 6 887-892, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
C. Jayr, M. Beaussier, U. Gustafsson, Y. Leteurnier, N. Nathan, B. Plaud, G. Tran, C. Varlet and J. Marty
We have compared the quality of three regimens of postoperative analgesia
(continuous epidural administration of ropivacaine (Ropi. group), epidural
ropivacaine and patient-controlled analgesia (PCA) with i.v. morphine
(Ropi. + PCA group) and PCA morphine alone (PCA group)) during the first
postoperative 24 h in a multicentre, randomized, prospective study.
Postoperative analgesia was studied in 130 patients after major abdominal
surgery performed under general anaesthesia. The ropivacaine groups
received 20 ml of epidural bolus ropivacaine 2 mg ml-1 via the epidural
route at the end of surgery, followed by continuous infusion of 10 ml h-1
for 24 h. The Ropi. + PCA group also had access to i.v. PCA morphine 1 mg,
with a 5-min lockout. The PCA group received morphine as the sole
postoperative pain treatment. The two ropivacaine groups had lower pain
scores (P < 0.01) than the PCA group. Morphine consumption was higher in
the PCA group (P < 0.05) than in the two ropivacaine groups. The quality
of pain relief was rated as good or excellent in 79-85% of patients in the
three groups. The percentage of patients without motor block increased
between 4 and 24 h from 61% to 89% in the Ropi. group, and from 51% to 71%
in the Ropi. + PCA group.
CLINICAL INVESTIGATIONS
Continuous epidural infusion of ropivacaine for postoperative analgesia after major abdominal surgery: comparative study with i.v. PCA morphine
Institut Gustave Roussy, Departement d'Anesthesie, Rue Camille Desmoulins, 94805 Villejuif Cedex, France; Hopital Saint Antoine, Departement d'Anesthesie, 184 Rue du Faubourg Saint Antoine, 75571 Paris Cedex 12, France; Clinical Research and Development, Astra Pain Control AB, Sodertalje, Sweden; CHU Hotel Dieu, Departement d'Anesthesie, Place Alexis Ricordeau, BP 1005, 44035 Nantes Cedex 01, France; Hopital Dupuytren, Departement d'Anesthesie, 2 Avenue Alexis Carrel, 87042 Limoges Cedex, France; de Nimes, Centre Gaston Doumergue, Departement d'Anesthesie, 5 Rue Hoche, 30006 Nimes Cedex, France; Hopital Jean Verdier, Departement d'Anesthesie, Avenue du 14 Juillet, 93143 Bondy Cedex, France; Hopital Beaujon, Departement d'Anesthesie, 100 Boulevard du General Leclerc, 92118 Clichy Cedex, France
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