Izvorni znanstveni članak

Continous wound infusion versus epidural postoperative analgesia after liver resection in carcinoma patients

LJILJA ŠTEFANČIĆ ; Department of Anesthesiology, Resuscitation and Intensive Medicine, Sestre milosrdnice University Hospital, Center, Zagreb, Croatia
GORDANA BROZOVIĆ ; Department of Anesthesiology, Resuscitation and Intensive Medicine, Sestre milosrdnice University Hospital, Center, Zagreb, Croatia
DEANA ŠTURM ; Department of Transfusion Medicine, Sestre milosrdnice University Hospital, Zagreb, Croatia
BRANKA MALDINI ; Department of Anesthesiology, Resuscitation and Intensive Medicine, Sestre milosrdnice University Hospital, Center, Zagreb, Croatia
KATA ŠAKIĆ ZDRAVČEVIĆ ; School of Medicine, University, J. J. Strossmayer Osijek

Sažetak

Background: Continuous wound infiltration (CWI) and epidural thoracic
analgesia (ETA) are analgesic techniques commonly used in the
multimodal management of postoperative pain after open abdominal surgery. The aim of this study was to evaluate the effectiveness in pain reduce and postoperative recovery of these techniques in patients scheduled for liver resection.

Methods: The retrospective study included 29 patients, with liver resection
performed due to metastases of colon carcinoma. The patients were
divided into two groups depending on type of postoperative analgesia.
Wound catheter group (WC) included patients that had received analgesia
through multiorifice wound catheter placed below the fascia and thoracic
epidural group (TEA) included that had received local anesthetic through a
epidural catheter. Both analgesic regimes were continued for 48 hours
postoperatively. All patients received a standard postoperative pain management protocol, including patient-controlled analgesia (PCA) morphine and intravenous diclofenac every 12h. Outcomes measured over 48 h after operation were Numerical Rating Score (NRS) et rest and coughing, morphine consumption, and side-effects (PONV) and time to bowel function recovery.

Results and Conclusion: No significant difference in morphine consumption
was observed between groups (p=0,395). Pain managment efficacy
was satisfactory (NRS <4) in both groups and we did not find significant differences in Numerical rating skale (NRS) between groups (p=0,128). We did not observed statisticaly significant differece in incidence of postoperative nausea and vomiting (PONV).Time to recover the bowel function was significantly reduced in WC Group 85,93 ±21,02 h and in TEA Group 107,64±20,02 h (p=.0,008).We conclude thatwound catheter infusion in liver surgery is simple, safe and even more effective alternative to epidural analgesia in multimodal protocol for postoperative analgesia after liver resection.

Ključne riječi

Hrčak ID:

105974

URI

https://hrcak.srce.hr/105974

Datum izdavanja:

1.6.2013.

Posjeta: 1.416 *