COMPARISON OF PATIENT-CONTROLLED EPIDURAL ANALGESIA WITH PATIENT­ CONTROLLED INTRAVENOUS ANALGESIA USING TRAMADOL

Abstract

This work was carried out on 40 patients undergoing open cholecystectomy to compare between PCEA and PCIA using tramadol for postoperative pain relief.

All patients were premedicated using diazepam 0.2 mg-Kg- 1- orally the night before and one hour before surgery. One hour before operation, all patients were instructed in the use ofPCA and how to use VAS.

FVC, FEV 1 and PEF were estimated before operation.

Operative monitoring was standard for all patients and consisted of ECG, Non invasive blood pressure, pulse oxymetry and end tidal C02. General anesthesia was induced using thiopental sodium 3-5 mg-Kg-1. Tracheal intubation was facilitated by pipecuronium bromide 0.05 mg.Kg- 1. Anesthesia was maintained by use of isoflurane .2-1% and 50% N20 in

oxygen. Intermittent positive pressure was continued throughout the operation.

After skin closure and under general anesthesia patients were turned to lateral decubitus position then the epidural catheter was inserted at L2-3 or L3-4 level.

Anesthetics were stopped and neuromuscular blockade was reversed 1

with neostigmine 0.05mg.Kg.

trachea was extubated.

plus atropine 0.4/lmg neostigand