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Quality of analgesia with multi-versus two few-hole catheters in patients after colorectal surgery

STELA MARIĆ ; University Hospital Center »Sestre Milosrdnice«, Department of Anaesthesiology and Intensive Care, Zagreb, Croatia
LJILJA ŠTEFANČIĆ ; University Hospital Center »Sestre Milosrdnice«, Department of Anaesthesiology and Intensive Care, Zagreb, Croatia
LJILJANA POPOVIć ; University Hospital Center »Sestre Milosrdnice«, Department of Anaesthesiology and Intensive Care, Zagreb, Croatia
MIROSLAV BANOVIĆ ; University Hospital Center, »Sestre milosrdnice«, Department of Transfusion Medicine, Zagreb, Croatia
KATA ŠAKIĆ ; Clinical Hospital »Sveti Duh«, Department of Anaesthesiology and Intensive Care, Zagreb, Croatia

Sažetak

Background and Purpose: Continuous wound infusionwith local anaesthetics is an effective method in multimodal postoperative pain therapy after colorectal surgery. The choice of optimal type of wound catheter, fewor multi-hole is still controversial. The aim is to evaluate the analgesic potential of these two catheter types.

Materials and Methods: Forty patients undergoing colorectal surgery
were randomized to intraoperative placement of two epidural catheters (Group EC) or multi-hole catheter (Group WC) in the wound above the fascia. Patients received 0.25% levobupivacaine (Group WC) with 10 mL bolus through the wound catheter followed by an infusion of 6 mL/h during 48 h, or the same protocol with equally divided levobupivacaine doses through two epidural catheters (Group EC). Simultaneously, patient-controlled analgesia provided intravenous morphine. Pain was evaluated postoperatively with 4-point verbal scale (VRS) for the first 2 h, with Visual Analogue Scale at rest (VAS r), and during coughing (VAS c) every 6 h for
the first 48 h.

Results and Conclusions: No significant difference in morphine consumption was observed between groups. There were no significant differences in VRS scores between the groups (p=0,756). VAS scores were significantly lower in Group WC in rest (rWC, p=0,007) and coughing (cWC, p=0,018) for the 6 h, 12 h, and 24 h postoperatively. In the period 30–48 h there was no difference between groups. We conclude that levobupivacaine infusion through multi-hole catheter provides better quality of postoperative
analgesia compared with two epidural catheters for the first 24 h.

Ključne riječi

regional anaesthesia; infiltration anaesthesia; pain; colorectal surgery

Hrčak ID:

68997

URI

https://hrcak.srce.hr/68997

Datum izdavanja:

1.6.2011.

Posjeta: 1.144 *