Effects of Preemptive Analgesia by Epidural Bupivacaine and Fentanyl on Postoperative Pain Control in Lower Abdominal Surgery

Lee, Jun Hak; Kim, In Ryeong; Yoon, Chae Sik; Chung, Eun Bae; Lee, Ki Nam; Moon, Jun Il

Abstract

BACKGROUND
Preemptive analgesia is an antinociceptive treatment that prevents the establishment of altered central processing which amplifies postoperative pain. A controversy exists over the effectiveness and clinical value of preemptive analgesia. We studied whether epidural bupivacaine and fentanyl prior to surgery could possibly affect postoperative pain and analgesic demands, as compared to administration of same at end of surgery.
METHODS
Forty patients scheduled for lower abdominal surgery were randomly assigned to one of two groups and prospectively studied in a double-blind method. Group 1 (n 20) received epidural injection of 15 ml bupivacaine 0,25% with fentanyl 100 microgram before surgery while group 2 (n= 20) received the same injection at the end of their surgery respectively. Postoperative analgesia consisted of basal plus patient-controlled mode of epidural bupivacaine and fentanyl from PCA system. Postoperative visual analog pain scores (VAPS), analgesics consumption, supplementary analgesics requirement and side effects were assessed for 3 postoperative days.
RESULTS
There were no significant difference in analgesics requirement and pain scores, at any time, during rest or after movement, in measurement between the groups.
CONCLUSIONS
We conclude no clinical value of effectiveness in administering epidural bupivacaine- fentanyl before surgery as compared to administration after surgery.