This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wattwil, M. Articles by Garvill, J-E Search for Related Content PubMed PubMed Citation Articles by Wattwil, M. Articles by Garvill, J-E

Epidural Analgesia With Bupivacaine Reduces Postoperative Paralytic Ileus After Hysterectomy

Departments of Anesthesiology and Intensive Care, Radiology, and Obstetrics and Gynecology, Örebro Medical Center Hospital, Örebro, Sweden. This study was presented in part at the 2nd International Symposium Regional Anesthesia, Williamsburg, Virginia, May 28–30,1988.

Abstract

This study was undertaken to compare the effects of postoperative bupivacaine epidural analgesia with those of intermittent injections of ketobemidone (a synthetic opioid) on postoperative bowel motility in patients who had had hysterectomies. The epidural group (N=20) received continuous epidural anesthesia with bupivacaine postoperatively for 26–30 hours and the control group (N=20) received intermittent injections of ketobemidone for postoperative pain relief. Postoperative bowel movements and propulsive colonic motility were estimated from the first passage of flatus and feces and by following radiopaque markers by serial abdominal radiographs. In the epidural group, the times for first passing of flatus (31 ± 22 hours; mean ± SD) and feces (70 ± 44 hours) were significantly shorter than in the control group (flatus 58 ± 14 hours and feces 103 ± 26 hours). The average position of the markers was significantly more distally in the epidural group immediately after operation and the markers continued to move forward during the first postoperative day. In the control group, the markers did not move during this period. The results demonstrate that postoperative bowel peristalsis returned earlier in the patients given epidural analgesia with bupivacaine for pain relief than in patients given a narcotic.

Key Words: ANALGESICS—opioids • ANESTHETICS LOCAL—bupivacaine • ANESTHETIC TECHNIQUES—epidural • GASTROINTESTINAL MOTILITY—colon • PAIN—postoperative • SURGERY, ABDOMINAL—hysterectomy

This article has been cited by other articles:

				M. Schuster, A. Gottschalk, M. Freitag, and T. Standl Cost Drivers in Patient-Controlled Epidural Analgesia for Postoperative Pain Management After Major Surgery Anesth. Analg., March 1, 2004; 98(3): 708 - 713. [Abstract] [Full Text] [PDF]

				A. Luckey, E. Livingston, and Y. Tache Mechanisms and Treatment of Postoperative Ileus Arch Surg, February 1, 2003; 138(2): 206 - 214. [Abstract] [Full Text] [PDF]

				H. Jorgensen, J. S. Fomsgaard, J. Dirks, J. Wetterslev, B. Andreasson, and J. B. Dahl Effect of peri- and postoperative epidural anaesthesia on pain and gastrointestinal function after abdominal hysterectomy Br. J. Anaesth., October 1, 2001; 87(4): 577 - 583. [Abstract] [Full Text] [PDF]

				H. Kehlet and K. Holte Effect of postoperative analgesia on surgical outcome Br. J. Anaesth., July 1, 2001; 87(1): 62 - 72. [Abstract] [Full Text] [PDF]

				C. L. Wu and L. A. Fleisher Outcomes Research in Regional Anesthesia and Analgesia Anesth. Analg., October 1, 2000; 91(5): 1232 - 1242. [Full Text] [PDF]

				D. S. Stevens and W. T. Edwards Management of Pain in the Critically Ill J Intensive Care Med, November 1, 1990; 5(6): 258 - 291. [Abstract] [PDF]