• Soichiro Inoue, Hiromasa Mitsuhata, Takayuki Kawakami, Keiko Shimohata, Yoshihiro Hirabayashi, and Norimasa Seo.
• Department of Anesthesiology and Critical Care Medicine, Jichi Medical School, Tochigi 329-0498, Japan. inoues@jichi.ac.jp
• J Clin Anesth. 2005 May 1;17(3):167-71.

Study ObjectiveTo compare the analgesic efficacy of additional 0.1% bupivacaine to patient-controlled epidural analgesia (PCEA) using buprenorphine and droperidol after gynecological surgery.DesignRandomized, double-blinded study.SettingOperating theater and general ward at Jichi Medical School Hospital.PatientsThirty patients with American Society of Anesthesiologists physical status I and II scheduled for gynecological surgery.InterventionsPatients received combined general and epidural anesthesia for surgery and epidural analgesia for postoperative analgesia. Patients were assigned to receive PCEA with or without 0.1% bupivacaine. Group 1 (n = 15) received buprenorphine 20 microg and droperidol 0.1 mg diluted with saline, and group 2 (n = 15) received bupivacaine 2 mg, buprenorphine 20 microg, and droperidol 0.1 mg diluted with saline (0.1% bupivacaine solution) in a bolus dose of the PCEA, respectively. No background epidural infusion was used.MeasurementsVisual analog pain scale (VAPS) scores at rest and on coughing, and cumulative frequency of self-administrated analgesic solution in PCEA were recorded at 24 and 48 hours postoperatively.Main ResultsThere were no significant differences noted between the groups in VAPS scores at rest or in cumulative volumes of PCEA solution in 24 or 48 hours postoperatively. Median VAPS scores on coughing in group 2 were significantly lower than those values in group 1 at 24 hours (36 vs 65 mm, P < .001) and 48 hours (32 vs 54 mm, P = .036) postoperatively.ConclusionsAddition of 0.1% bupivacaine to PCEA using buprenorphine and droperidol provides better analgesia on coughing after gynecological surgery.

28 keywords...

hide…