Peritoneal Irrigation of Fentanyl Added to Levo- Bupivacaine Versus Patient Controlled Intravenous Analgesia (PCIA) in Patients Undergoing Major Abdominal Cancer Surgeries

Volume 1 - Issue 3

Alaa Ali M Elzohry¹*, Ahmed Fetouh Abdelrahman², Ali Taha Abdel Wahab³, Wegdan A Ali³ and Mohamed Abd El moniem Bakr⁴

Received: May 20, 2019;   Published:May 24, 2019

DOI: 10.32474/GJAPM.2018.01.000113

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Abstract

Background: Major abdominal surgeries still the main line of treatment for upper abdominal malignancies and these surgeries induce severe postoperative pain with different types either somatic or visceral. If such pain not controlled, may cause various organ dysfunctions and prolong both hospital and ICU stay. So, an appropriate pain therapy to those patients with least complications must be applicated.

Objective: To compare analgesic efficacy of intraperitoneal irrigation of fentanyl added to levo-bupivacaine versus patient controlled intravenous analgesia in patients undergoing major abdominal cancer surgeries.

Methods: 120 patients (ASA II-III) of either sex were scheduled for elective upper abdominal cancer surgeries. Patients were randomly allocated into three groups (40 patients each), to receive: post-operative PCA fentanyl through IV rout (group I), intraperitoneal irrigation of Levo-bupivacaine 25% in 50 ml volume (group II), or intraperitoneal irrigation of Levo-bupivacaine 25% plus fentanyl 200 mic in 50 ml volume (group III). Postoperative pain was assessed over 48 h using Numerical rating scale (NRS). The intra and post-operative haemodynamics, sedation score and overall post-operative patient fentanyl consumption were recorded. Any concomitant events like nausea; vomiting, pruritus or respiratory complications were recorded postoperatively.

Keywords: Intraperitoneal irrigation; Major upper abdominal cancer surgeries; Postoperative pain; NRS scale; Fentanyl; Levo bupivacaine

Abstract| Introduction| Patients and Methods| Standard General Anesthesia| Statistical Analysis| Results| Discussion| Conclusion| References|