Combined Continuous Epidural Administration of Midazolam-Buprenorphine-Bupivacaine for Post-Gastrectomy Analgesia
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Accession number;04A0208956
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| Title;Combined Continuous Epidural Administration of Midazolam-Buprenorphine-Bupivacaine for Post-Gastrectomy Analgesia |
| Author;
NISHIYAMA T
(Univ. Tokyo, Tokyo, Jpn)
HANAOKA K
(Univ. Tokyo, Tokyo, Jpn)
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Journal Title;Hiroshima Journal of Anesthesia
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Journal Code:S0305A
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ISSN:0385-1664
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VOL.39;NO.2;PAGE.53-56(2003)
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| Figure&Table&Reference;TBL.5, REF.19 |
| Pub. Country;Japan |
| Language;English |
| Abstract;To investigate the effects of midazolam added to continuous epidural administration of buprenorphine and bupivacaine on postoperative analgesia and side effects, 60 patients aged 45 to 75 for gastrectomy without any complications were divided into three groups with 20 patients each. At the end of surgery, the following agents were epidurally administered, Group A, 0.25% bupivacaine 5ml+buprenorphine 0.1mg followed by 0.25% bupivacaine 37ml+buprenorphine 0.2mg in 24 hours; Group B, 0.25% bupivacaine 5ml+buprenorphine 0.1mg+midazolam 3mg followed by 0.25% bupivacaine 37ml+buprenorphine 0.2mg+midazolam 10mg in 24 hours Group C: 0.25% bupivacaine 5ml+buprenorphine 0.1mg followed by 0.25% bupivacaine 37ml+buprenorphine 0.4mg in 24 hours. Total volume of the continuous infusion in all groups was mede to 40ml with saline. As an analgesic supplement, epidural 4 to 5ml 0.25% bupivacaine was the first choice and intramuscular pentazocine 15mg was the second choice when patients requested analgesics. Analgesia (visual analog scale,VAS), sedation, blood pressure, heart rate, and respiratory rate were monitored for 24 hours. The frequencies of analgesic supplements and the number of patients with nausea and/or vomiting in 24 hours were also compared among the groups. The VAS scores were significantly lower in the Group B and Group C than in the Group A. More analgesic supplements were necessary in Group A than in the other two. The number of the patients with nausea and/or vomiting was 6, 4, and 9 in Groups A, B, and C, respectively. Hemodynamics, respiration, and sedation level were not different among the groups. In conclusion, adding midazolam to epidural buprenorphine+bupivacaine was useful for post-gastrectomy analgesia to enhance analgesia with decreasing side effects. (author abst.) |
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