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Abstract
Provision of sedation, analgesia and amnesia during the intra and postoperative period is one of the most challenging problems facing the anesthesiologist. The aim of this work was to evaluate the efficacy of epidural bupivacaine alone or in combination with verapamil or verapamil in the management of pain both intraoperative and postoperative in upper abdominal, urological and orthopedic surgery. In this study 90 patients were divided into 3 groups:
In group I:
After induction of general anesthesia, 15 ml of 0.25 bupivacaine was injected in the epidural catheter 15 min. before skin incision, and at the end of surgery.
In group II:
After induction of general anesthesia, 13 ml of 0.25% bupivacaine and 5 mg verapamil (2ml) were injected in the epidural catheter 15 min. before skin incision and at the end of surgery.
In group III:
After induction of general anesthesia, 5 mg verapamil in 5 ml of normal saline were injected in the epidural catheter 15 min before skin incision and at the end of surgery.
The following measures were taken postoperatively:
The pain score, sedation score, serum glucose and cortisol, Hemodynamics (heart rate, systolic and diastolic blood pressure). The total amount of pethidine used at the end of 24hrs and the time of fist analgesic dose. The results of the statistical analysis of data obtained can be summarized as follows:
There was statistically significant difference between the 3 groups as regard pain score, also serum glucose and cortisol.
There was no statistically significant difference between the 3 groups as regard sedation score except in the first 2 hours, heart rate, systolic blood pressure and diastolic blood pressure.
There was significant decrease in total dose of pethidine required and also there was a delay in intake of first analgesic dose.