Single-Shot Morphine vs. Continuous Bupivacaine for Post-Op Pain
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Comparison of Single-Shot Intrathecal Morphine Injection and Continuous Epidural Bupivacaine for Post-Operative Analgaesia after Elective Abdominal Hysterectomy
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Wan Mohd Nazaruddin Wan Hassan, Anafairos Md Nayan, Azmi Abu Hassan, Rhendra Hardy Mohamad Zaini
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Comparison of Single-Shot Intrathecal Morphine Injection and Continuous Epidural Bupivacaine for Post-Operative Analgaesia after Elective Abdominal Hysterectomy
Year: 2017 | Doi: 10.21315/mjms2017.24.6.3
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Abdominal hysterectomy (AH) is associated with significant postoperative pain, with many patients reporting moderate to severe discomfort within the first 24 hours following surgery. Effective pain management is crucial for patient comfort, early mobilization, and overall recovery. This study aimed to compare the effectiveness of two analgesic techniques: intrathecal morphine (ITM) and epidural bupivacaine (EB), in managing post-operative pain after elective AH.
Comparative Effectiveness of ITM and EB
The study involved 32 patients randomly assigned to receive either ITM (0.2 mg morphine combined with 2.5 mL of 0.5% bupivacaine) or EB (0.25% bupivacaine bolus with continuous infusion of 0.1% bupivacaine-fentanyl). Results indicated that the median Visual Analog Scale (VAS) scores for pain were significantly lower in the ITM group than the EB group at several time points after surgery (1st, 4th, 8th, and 16th hours). Additionally, the total morphine consumption was reduced in the ITM group, and patients mobilized earlier compared to those receiving EB. However, both groups provided adequate analgesia with comparable VAS scores over 24 hours, with side effects being similar between the two techniques but with a slightly higher incidence of nausea and pruritus in the ITM group.
Conclusion
The findings suggest that ITM is a superior technique for managing acute post-operative pain in AH patients in the initial hours after surgery, demonstrating lower pain scores and reduced opioid consumption. Both ITM and EB ultimately ensure acceptable pain control, indicating that both methods are valid options for postoperative analgesia. The study supports the use of ITM as a less invasive, safer, more efficient, and cost-effective alternative to traditional epidural analgesia in this surgical context.
FAQ section (important questions/answers):
What was the goal of the study comparing ITM and EB?
The study aimed to compare the analgesia effectiveness of intrathecal morphine (ITM) and epidural bupivacaine (EB) following abdominal hysterectomy surgery to assess pain levels and medication consumption.
How many patients were involved in the study and what were the groups?
Thirty-two patients scheduled for elective abdominal hysterectomy were randomized into two groups: Group ITM received intrathecal morphine while Group EB received epidural bupivacaine.
What were the main findings regarding pain scores between the two techniques?
Pain scores measured by the Visual Analogue Scale were significantly lower for ITM compared to EB at various time points post-surgery, indicating better early pain management with ITM.
Did the study find any significant differences in side effects?
Overall, the study observed no significant differences in side effects between the two groups, although Group ITM did have a higher incidence of nausea and pruritus.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Single-Shot Morphine vs. Continuous Bupivacaine for Post-Op Pain”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
The term 'Table' refers to a systematic arrangement of data, often used in research studies to clearly present and compare results. In this study, tables are employed to convey important findings such as demographic information, pain scores, and drug consumption, facilitating comprehension and analysis of the data
2) Pain:
Pain is a crucial subject in medical research, particularly in postoperative settings like abdominal hysterectomy. Effective pain management is vital for patient recovery, influencing quality of life, mobility, and overall satisfaction. This study examines various analgesic methods to assess their efficacy in managing pain post-surgery.
3) Study (Studying):
The 'Study' denotes a structured investigation into a specific research question, aiming to gather evidence or insights. This study compares the effectiveness of intrathecal morphine versus epidural bupivacaine for pain relief after abdominal hysterectomy, contributing valuable data to the field of postoperative analgesia.
4) Post:
The term 'Post' indicates the period following a surgical procedure, such as post-operative care where effective pain management is critical. This study focuses on post-operative pain control, evaluating the duration and quality of relief provided by different analgesic techniques during the recovery phase.
5) Drug:
In the context of this study, 'Drug' refers to pharmaceutical substances used for therapeutic purposes, particularly analgesics. Intrathecal morphine and epidural bupivacaine are evaluated for their effectiveness in alleviating pain after surgery, highlighting the importance of drug choice in pain management strategies.
6) Nausea:
Nausea is a common side effect associated with various analgesics and surgical interventions. It significantly impacts patient comfort and recovery post-surgery. This study records instances of nausea in patients receiving intrathecal morphine versus epidural bupivacaine, adding to the understanding of side effects related to these pain management techniques.
7) Cancer:
While 'Cancer' may not be the primary focus of this study, it represents a critical factor in abdominal surgeries. Patients with cancer-related issues may experience different pain management needs, weighing the efficacy of intrathecal morphine and epidural bupivacaine in this context could provide insight into tailored analgesic approaches.
8) Calculation:
The term 'Calculation' relates to the statistical assessments conducted in the study to evaluate data significance. Calculations are vital in determining sample size, comparing outcomes, and analyzing drug efficacy, ensuring robust and reliable conclusions about which analgesic method provided better pain control.
9) Rules:
In this context, 'Rules' could refer to the guidelines or protocols established for conducting the study and analyzing the data. Adhering to specific rules ensures the consistency, validity, and reliability of results, which is crucial when comparing different methods of analgesia in clinical research.
10) Vomiting:
Vomiting is another potential side effect linked to postoperative analgesics. Similar to nausea, it can detrimentally impact the recovery experience. The study evaluates and records any vomiting incidents among participants, seeking to understand the comparative safety profile of intrathecal morphine versus epidural bupivacaine.
11) Gold (Golden):
The word 'Gold' usually signifies a standard or benchmark in a given field. In this study, it is used to reference the previous paradigm that considered epidural analgesia the 'gold standard' for postoperative pain management. The study seeks to determine whether intrathecal morphine can match or exceed this standard.
12) Ghadi (Ghadi°):
In this research, the term 'Ghadi' refers to a specific author noted for their contributions to the literature surrounding intrathecal and epidural analgesia. Citing researchers helps validate findings and situates the current study within the broader context of pain management research.
13) Blood:
The term 'Blood' plays a significant role in anesthesia and surgical procedures, as it is vital for assessing patient stability. Monitoring blood pressure is crucial during surgeries involving postoperative analgesia, and drops in blood pressure can indicate complications requiring immediate attention.
14) Janta (Jamta):
Similar to 'Ghadi', 'Janda' denotes another author whose work is relevant to the study's topic. Properly referencing authors strengthens the credibility of the research and encourages its findings to be viewed in relation to existing literature on analgesic techniques.
15) Ter:
The term 'Ther' seems to be an abbreviation likely related to therapeutic approaches, particularly in specifying the nature of treatment or interventions provided during the study. It's essential to clarify the therapeutic context in discussions about analgesic efficacy in pain management.
16) Surrounding:
The term 'Surrounding' in this medical context usually relates to other anatomical structures or conditions that may influence surgical outcomes or pain experiences. Understanding surrounding conditions or complications can inform better treatment strategies and patient management techniques.
17) Accumulation (Accumulating, Accumulate):
In this research, 'Accumulated' refers to the total amount of medication or pain relief drugs administered or consumed over a specified period, particularly post-operatively. This accumulation is essential in evaluating the overall effectiveness and safety of analgesic techniques during patient recovery.
18) Discussion:
The 'Discussion' section of a study synthesizes results, contextualizes findings, and interprets implications. It explains how the data influences current practices in pain management and compares findings to existing literature to provide a comprehensive overview of intrathecal morphine versus epidural bupivacaine.
19) Depression:
In the medical context, 'Depression' can refer to both psychological factors impacting recovery and physiological effects such as respiratory depression due to analgesic medications. This study may touch upon such outcomes as part of assessing the safety and efficacy of pain control methods.
20) Attending:
The term 'Attending' here likely refers to healthcare staff responsible for patient care and monitoring during the study. The attending anaesthetist plays a critical role in administering treatments and evaluating patient responses, contributing significantly to the study's integrity.
21) Quality:
Quality is an essential measure in healthcare, particularly concerning the effectiveness of pain management strategies. This study assesses the quality of analgesia provided by intrathecal morphine versus epidural bupivacaine, determining their impact on patients' post-operative experiences and overall satisfaction.
22) Labour (Labor):
While 'Labour' primarily refers to childbirth, it may indicate contexts where analgesia techniques are compared, showing varied effectiveness. Although not the direct focus of this study, understanding methods in labour could yield insights applicable to similar analgesic approaches in postoperative care.
23) Pulse:
In medical monitoring, 'Pulse' refers to the heartbeat's frequency, essential for evaluating a patient’s cardiovascular stability during and after surgery. Maintaining a stable pulse is vital for patient safety when administering pain relief options like intrathecal morphine and epidural bupivacaine.
24) Pose:
The term 'Pose' can indicate potential risks or challenges that analgesic methods might present during surgery or recovery. Understanding these poses helps medical professionals mitigate risks and select the most effective and safe pain management strategies for patients.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Single-Shot Morphine vs. Continuous Bupivacaine for Post-Op Pain’. Further sources in the context of Science might help you critically compare this page with similair documents:
Nausea, Pain relief, Maximum Dose, Adverse effect, Blood-pressure, Pruritus, Pain management, Statistical analysis, Medical care, Patient, Significant difference, Inclusion criteria, Exclusion criteria, Statistical Significance, Body mass index, Ethics committee, Study group, Analgesic effect, Demographic Data, Study design, Visual analog scale, Visual analogue scale, Cost effective, VAS Score, Systematic Review, Pain score, Surgical removal, Post-operative period, Study protocol, Length of stay, Spinal anaesthesia, Post-operative pain, Hypotension, Patient satisfaction, Hospital stay, Surgical technique, Epidural analgesia, Side effect, General anaesthesia, Post-operative analgesia, Local anaesthetic, Length of Hospital Stay, Abdominal Hysterectomy, Early mobilisation, Ethical issue, Daily routine practice, Epidural anaesthesia, Cost of care, Hospital stay duration, Epidural bupivacaine, Randomised controlled trial, Pre operative assessment, Patient comfort, Major surgery, Technical support, ASA classification, Epidural catheter, Data interpretation, Single injection, Combination technique, Single-blinded study, Anaesthetic technique, Local anaesthetic agent, Less time consuming, Gynaecological surgery, Study material, Epidural technique.