J Korean Pain Soc.
2000 Jun;13(1):44-48.
Is Initial Loading Dose Necessary for Continuous Epidural Analgesia after Brief Surgery?
- Affiliations
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- 1Department of Anesthesiology, College of Medicine, Inha University, Inchon, Korea.
Abstract
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BACKGROUND: The continuous epidural analgesia is a popular method in the management of
post-operative pain. However, the exact regimen for the optimal analgesia is still in
dispute. In this study, we evaluated the effect of an initial loading dose prior to the
continuous epidural infusion after a brief surgery, which may have some residual effects
of local anesthetics that is used for the intraoperative epidural anesthesia.
METHODS
Seventy five patients required epidural anesthesia with 15 ml of 2% mepivacaine for the perianal surgery were randomly divided into three groups: Group 1, being the control group (n 25) did not received postoperative epidural pain control. But, group 2 (n 25) and 3 (n 25) received continuous epidural analgesia with local anesthetics and morphine immediately after surgery. In Group 2, the patients received continuous epidural infusion without initial loading dose. In Group 3, the patients received initial loading dose (1% mepivacaine 6 ml and morphine 1 mg) and followed by continuous epidural infusion. We evaluated the number of patients who needed adjuvant analgesics, the pain score, and incidence of side effects for the postoperative 48 hours.
RESULTS
At postoperative 12 hours, in group 3, the two variables, the number of patients who needed analgesics and the pain score showed a statistical significance with low scores compared with group 1 and 2. At postoperative 24 and 48 hours, the two variables indicated above did not show any differences in group 2 and 3. The incidence of side effects is not different among the three groups.
CONCLUSIONS
The loading dose prior to continuous epidural infusion is necessary after a brief surgery which may have some residual effects of local anesthetics that is used for the intraoperative epidura anesthesia.
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