The Use of Epidural Catheter for Anaesthesia and Relieving of Postoperative Pain in Transvesical Prostatectomy Using Bupivacaine

Razzaq Al-Salman, Abdul; Shamkhi, Rafid

	The Use of Epidural Catheter for Anaesthesia and Relieving of Postoperative Pain in Transvesical Prostatectomy Using Bupivacaine
Medical Journal of Babylon
Article 1, Volume 8, Issue 3, 2011, Pages 350-355
Authors
Abdul Razzaq Al-Salman; Rafid Shamkhi
Abstract
Objective: To determine the impact of preemptive epidural anaesthesia and analgesia on postoperative pain and other clinically important outcome variables after transvesical retropubic prostatectomy. Patients and method: A total of 28 patients undergoing transvesical prostatectomy for the treatment of benign prostatic hypertrophy were randomized to either group A (10 patients underwent the surgery under general anaesthesia. And the other 18 patients scheduled in whom an epidural catheter for anaesthesia and treating postoperative pain. Epidural bupivacaine 0.5%, was administered for induction of anesthesia and throughout the entire operation, followed by aggressive postoperative epidural analgesia for all patients in group B, pain scores obtained 48 hours,Pain recorded by using visual analogue scale VAS.Evaluation of our perioperative anaesthesiologic regimen, in terms of safety, patient comfort, the time in operating room and recovery room, average blood loss(depending on pcv & Hb%). time to return of bowel function, duration for need to bladder wash. Results: There were no significant differences between the groups with respect to age, height, weight, or operation time. Regarding the operative time in the operating room revealed no differences in both groups ( 60--90 minutes including the time of induction of anaesthesia),but the time needed in recovery room for those patients with GA about 15—40 minutes. The recovery time of bowel function in group B (8—12 hours) was less than that for group A ( 16—24 hours).The duration for irrigation of bladder wash in group A was 42--72 hours, while for those in group B was 24—42 hours. The need for blood transfusion in 6/10(60%) in group A, and 4/18(22%) in group B. The postoperative pain score using VAS, The results revealed there is a significant difference of the pain score between group A(7.65+/- 1.56), and 1.25+/-0.2 in group B Conclusions: The epidural catheter for anaesthesia and preemptive administration of epidural analgesics can lead to long-term decreases in postoperative pain and earlier resumption of normal activities.

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