A Hospital Based Study Assessing Epidural or Intrathecal Morphine for Post-Operative Analgesia Following Laparoscopic Endometriosis Surgery: An Observational Study

Soumya Singh, Amit Kumar Singh, Uma Shanker Singh
2023 · doi:10.5281/zenodo.12651148 · W6892862839
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This observational hospital-based study evaluated postoperative pain and analgesic use among 100 patients undergoing laparoscopic surgery described as endometriosis surgery at AIIMS Patna over 10 months. Most participants were overweight or had class III obesity, and 65% reportedly received no analgesia before surgery; postoperative treatment commonly included opioids, NSAIDs, and paracetamol during the first two days. Mean pain scores were significantly higher at one week, four weeks, and six months, but not at three months, while analgesic use became comparable between groups after 60 days. The report inconsistently refers to endometrial cancer rather than endometriosis and does not clearly describe the comparison between epidural and intrathecal morphine. This paper is centrally about endometriosis — postoperative analgesia and pain following laparoscopic surgery.

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Abstract

Aim: The aim of the present study was to assess epidural or intrathecal morphine for postoperative analgesia following laparoscopic endometriosis surgery.Methods: The present study was conducted at department of Anesthesiology, AIIMS, Patna,Bihar, India for 10 months and 100 patients were included in the study.Results: Majority of the patients (28%) were belonged to overweight (25.00–29.99) categoryfollowed by 22% Obesity class III (≥40). 75% cases completed ≤12 years of school and 65%were married. 65% had no analgesia followed by 32% non-opioid analgesia. Mean painscores were significantly higher at one week (1.62, � < 0.0001), four weeks (0.63, � = 0.02),and six months (0.27, � = 0.04), but not at three months following surgery. During the firsttwo postoperative days, opioid analgesia (98%, � = 0.09) and NSAIDS (60%, � = 0.7), asignificantly higher proportion of patients required Paracetamol (95%, � = 0.03). At 3–5 daysafter surgery. Analgesic use was comparable between groups after 60 days after surgery.Conclusion: The results of this study showed that laparoscopic surgery for endometrialcancer is associated with less need for epidural and postoperative analgesic prescriptioncompared with open surgery, saving on costs of analgesia and highlighting a furthersignificant benefit to patients and the healthcare system of laparoscopic treatment overtraditional open abdominal surgery.
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Methods

The present study was conducted at department of Anesthesiology, AIIMS, Patna, Bihar, India for 10 months and 100 patients were included in the study.

Results

Majority of the patients (28%) were belonged to overweight (25.00–29.99) category followed by 22% Obesity class III (≥40). 75% cases completed ≤12 years of school and 65% were married. 65% had no analgesia followed by 32% non-opioid analgesia. Mean pain scores were significantly higher at one week (1.62, � < 0.0001), four weeks (0.63, � = 0.02), and six months (0.27, � = 0.04), but not at three months following surgery. During the first two postoperative days, opioid analgesia (98%, � = 0.09) and NSAIDS (60%, � = 0.7), a significantly higher proportion of patients required Paracetamol (95%, � = 0.03). At 3–5 days after surgery. Analgesic use was comparable between groups after 60 days after surgery.

Conclusion

The results of this study showed that laparoscopic surgery for endometrial cancer is associated with less need for epidural and postoperative analgesic prescription compared with open surgery, saving on costs of analgesia and highlighting a further significant benefit to patients and the healthcare system of laparoscopic treatment over traditional open abdominal surgery.

Abstract

(English) Aim: The aim of the present study was to assess epidural or intrathecal morphine for postoperative analgesia following laparoscopic endometriosis surgery.

Methods

The present study was conducted at department of Anesthesiology, AIIMS, Patna, Bihar, India for 10 months and 100 patients were included in the study.

Results

Majority of the patients (28%) were belonged to overweight (25.00–29.99) category followed by 22% Obesity class III (≥40). 75% cases completed ≤12 years of school and 65% were married. 65% had no analgesia followed by 32% non-opioid analgesia. Mean pain scores were significantly higher at one week (1.62, � < 0.0001), four weeks (0.63, � = 0.02), and six months (0.27, � = 0.04), but not at three months following surgery. During the first two postoperative days, opioid analgesia (98%, � = 0.09) and NSAIDS (60%, � = 0.7), a significantly higher proportion of patients required Paracetamol (95%, � = 0.03). At 3–5 days after surgery. Analgesic use was comparable between groups after 60 days after surgery.

Conclusion

The results of this study showed that laparoscopic surgery for endometrial cancer is associated with less need for epidural and postoperative analgesic prescription compared with open surgery, saving on costs of analgesia and highlighting a further significant benefit to patients and the healthcare system of laparoscopic treatment over traditional open abdominal surgery. Files IJCPR,Vol15,Issue3,Article24.pdf Files (383.6 kB) | Name | Size | Download all | |---|---|---| | md5:01981f0407a1f0bb65e7ff94b64772c7 | 383.6 kB | Preview Download | Additional details Dates - Accepted - 2023-03-03

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