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2006, Number 1

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Rev Mex Anest 2006; 29 (1)

Post-surgical epidural analgesia. Comparative and blinded study between fentanyl/bupivacaine vs morphine/bupivacaine

Ramírez-Guerrero JA, Gutiérrez-Sougarret B

Language: Spanish
References: 42
Page: 15-19
PDF size: 63.40 Kb.


ABSTRACT

Objective: A prospective, double blind study was carried out to compare the efficacy and side effects of epidural analgesia with fentanyl/bupivacaine vs morphine/bupivacaine. Materials and methods: Fifty-seven patients undergoing major abdominal surgery with either epidural or combined general/epidural anesthesia were included. Twenty-eight patients received a bolus of 50 mg fentanyl, followed by continuous infusion of 120 mL, 6 mg/mL fentanyl solution plus 0.065% bupivacaine, 5 mL/h. Twenty-nine patients received a bolus of 2 mg morphine, followed by continuous infusion of 120 mL, 0.065% bupivacaine solution plus 3 mg morphine, 5 mL/h. The following were assessed in a double-blind fashion: pain at rest and during inspiration (on a visual analogue scale); pruritus (mild, moderate, severe); nausea that warranted treatment; and vomiting. Results: No differences in pain relief were observed. The incidence of nausea (48% vs 18%), vomiting (38% vs 3.5%) and pruritus (31% vs 7%) was significantly higher in the morphine group. Conclusion: Epidural analgesia with fentanyl/bupivacaine is associated with less side effects, probably due to pharmacokinetic differences between fentanyl and morphine on the spinal cord.


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