Post operative analgesia with continuous epidural infusion

Forty eight ASA I or II patients of either sex between 20-70 years undergoing major upper abdominal surgery were grouped into sixteen each, on complaint of pain. They received an epidural bolus dose, followed by infusion of the assigned drug at 4ml per hour through BARD PCA I pump. Pain assessment, for the first four hours, was hourly, and subsequently at l0th, 16th, 22nd, 28th, 36th and 40th hour by VAS and VRS. The groups matched for demographic distribution. All groups had lower mean pain scores at first hour by VAS and VRS. In Group II and Group III, the difference was significant (<0.05) at the 2nd (VAS) and 4th (VRS) hours. From 16th (VAS) and 22nd (VRS) hours, the mean pain score was less and significant (<0.05) in Group III. In all groups sedation ranged from 0-1. There was hypotension in Group I (2/16).urinary retention in Group II (8/9 not catheterised); unilateral sensory impairment and motor weakness in Group I (3/16) and Group III (1/16). This study showed that continuous infusion of low dose morphine with bupivacaine provides better quality post operative analgesia with fewer side effects than bupivacaine or morphine alone.