Preemptive Intraperitoneal Bupivacaine does not Provide Analgesia after Transabdominal Hysterectomy
Parakkamodom S, Visalyaputra S*, จิตนันท์ พินธุรักษ์, ฉันทนา งามสง่า, พรรษมน เผดิมวงศ์, วิมลลักษณ์ สนั่นศิลป์, สถาพร ปรุงศรี, สามารถ ตันติภูษานนท์, สิริลักษณ์ วุฑฒิกรรมรักษา, อนินทิตา ปิติวรรณDepartment of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700
บทคัดย่อ
A contraversy exists over the effectiveness and clinical value of preemptive analgesia. To investigate the preemptive effects of intraperitoneal bupivacaine, a randomized double blinded placebe controlled study was done in 62 patients undergoing transabdominal hysterectomy under general anesthesia. Patients in group A (placebo) received 80 ml of intraperitoneal instillation of normal saline with epinephrine 0.2 mg after the abdominal cavity had been opened but before the surgical manipulation of the uterus. Patients in group B (bupivaciane) received 80 ml of 0.125 % bupivacaine with epinephrine 0.2 mg instead of normal saline in the same manner as group A. Pain which was assessed by patients using visual analogue scale at 2, 6, 18, 24 h after surgery and the analgesic requirements were not significant different between the two groups. Metabolic endocrine responses (cortisol levels) were not different either. Plasma bupivacaine levels were investigated. We concluded that intraperitoneal instillation of bupivacaine cannot preempt postoperative pain indicated by cortisol levels, visual analogue scores and postoperative morphine requirement.
ที่มา
วิสัญญีสาร ปี 2542, October-December
ปีที่: 25 ฉบับที่ 4 หน้า 242-246