الفهرس 
postoperative painOnly 14 pages are availabe for public view
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Abstract
Patient-controlled epidural analgesia (PCEA) may offer the opportunity to reduce the incidence of side effects associated with CEI, since PCEA provides excellent postoperative analgesia with only minimal side effects when properly used. Both improved analgesia with similar doses of analgesics and dose-sparing effects with comparable analgesia have been shown for PCEA when compared with CEI. This present prospective randomized double-blinded study was designed to evaluate the efficacy of PCEA on postoperative analgesia, motor blockade and side effects using ropivacaine with different additives; fentanyl, ketamine, and neostigmine after abdominal malignancy surgery. There was comparable and satisfactory analgesia in all patients of the four groups but there were reduction in total volumes of analgesic regimens and the number of successive bolus demands in RF, RK and RN groups in comparison to R gp. Also in R gp., there were decrease in mean arterial blood pressure, heart rate and increase in incidence of nausea and vomiting, the incidence of motor block in comparison to the other three groups . There were insignificant differences among the four groups as regard sedation score. Lastly there were high score of satisfaction in RF, RK and RN groups in copmparison to R gp. In conclusion, the addition of either fentanyl, ketamine or neostigmine in such prescribed regimen to PCEA with ropivacaine in abdominal malignant surgeries was associated with comparable analgesia, with the reduction of the incidence of adverse effects; motor blockade, decrease in HR, mean arterial blood pressure, and nausea & vomiting rather than the usage of ropivacaine as a sole agent.