Combined spinal-epidural analgesia vs. intermittent bolus epidural analgesia for pain relief after major abdominal surgery. A prospective, randomised, double-blind clinical trial

Abstract

Combined spinal-epidural improved intra-operative analgesia and reduced pain with cough in the immediate postoperative period. The addition of fentanyl to subarachnoid morphine and bupivacaine decreased the need for additional i.v. fentanyl and epidural bupivacaine analgesia.

Comparison of analgesic effect of intrathecal morphine alone or in combination with bupivacaine and fentanyl in patients undergoing total gastrectomy: A prospective randomised, double blind clinical trial

“…Use of intrathecal opioids and local anesthetics in combination with epidural anesthesia/analgesia proved to provide reliable intraoperative and postoperative analgesia in major abdominal surgery, especially colorectal surgery [2][3][4] . Use of intrathecal opioids and local anesthetics in combination with epidural anesthesia/analgesia proved to provide reliable intraoperative and postoperative analgesia in major abdominal surgery, especially colorectal surgery [2][3][4] .…”

Analgesia pós-operatória: Comparação entre Bloqueio Interpleural e Anestesia Peridural

“…Pesquisa clínica, prospectiva, aleatória e duplamente encoberta, comparando a eficácia da analgesia subaracnoidea-peridural com a analgesia em bolus intermitente por via peridural, para alívio da dor em cirurgias abdominais concluiu que: a associação subaracnoidea-peridural melhora a analgesia no trans-operatório e diminui a intensidade da dor ao tossir no pósoperatório imediato; a adição de fentanil à morfina e bupivacaína pela via subaracnoidea diminui a necessidade de complementação analgésica com fentanil por via venosa ou bupivacaína por via peridural. 12 Neste estudo a analgesia pós-operatória obtida nos pacientes submetidos à anestesia peridural foi superior em relação ao bloqueio interpleural, nos períodos de 6-12h, 12-18h e 18-24h; necessitaram administração de opióide três pacientes sobmetidos à anestesia peridural e oito ao bloqueio interpleural.…”

Combined spinal-epidural technique: Single-space vs double distant space technique

“…In this study we used the technique described in earlier publications, which includes epidural puncture for epidural catheter placement in the thoracic region, combined with spinal puncture and a single subarachnoid injection at a lumbar level (double distant space -DDS) 4,5 .…”