کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4287839 | 1612051 | 2007 | 5 صفحه PDF | دانلود رایگان |

The present study compared three postoperative pain management techniques in patients undergoing lower abdominal surgery: intermittent opiate regimen (IOR), patient-controlled analgesia (PCA), and patient-controlled epidural analgesia (PCEA), on cortisol and prolactin levels during the first 48 h postoperatively.Ninety-two patients scheduled for a lower abdominal surgery, were randomly assigned to one of three study groups: IOR (N = 31), PCA (N = 31), and PCEA (N = 30). Patients of the IOR group received postoperatively 50–75 mg of pethidine IM on demand. Patients of the PCA group received a loading dose of morphine (3–4 mg), followed by 1 mg bolus of morphine IV per demand. Patients of the PCEA group received 3 ml of 0.1% bupivacaine plus 2 μg/ml of fentanyl per demand, with continuous background infusion of 6 ml/h. Venous blood samples were collected preoperatively, and 24 and 48 h after surgery, and were later assayed for serum cortisol and prolactin levels.Patients of the PCEA group exhibited diminished postoperative elevation of serum cortisol levels at 24 and 48 h (24.4, 18.6 μg/dl, respectively) compared with both IOR (31.9, 21.9) and PCA (28.5, 22.3) groups. Similarly, patients of the PCEA group exhibited diminished postoperative elevation of serum prolactin level (20.7, 15.7 ng/mL) compared with PCA (24.9, 17.1) group.The present results indicate that the PCEA technique offers an advantageous treatment associated with reduced postoperative pain, and attenuated neuroendocrine response.
Journal: International Journal of Surgery - Volume 5, Issue 4, August 2007, Pages 239–243