A Prospective Observational Hospital-Based Assessment of the Epidural or Intrathecal Morphine for Post-Operative Analgesia Following Laparoscopic Endometriosis Surgery

Bhagwan Das, Deepak Kumar, Pramod Kumar Sinha
2023 · doi:10.5281/zenodo.12626410 · W6930387522
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This study assessed epidural or intrathecal morphine for postoperative analgesia following laparoscopic endometriosis surgery, finding that pain scores were significantly higher at one, four, and six weeks but comparable between groups after sixty days.

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This prospective observational study evaluated postoperative analgesia requirements in 100 patients undergoing laparoscopic procedures at a hospital in India over a fifteen-month period. The results indicated that mean pain scores were significantly elevated at one week, four weeks, and six months post-surgery, with high initial reliance on opioid and non-steroidal anti-inflammatory drugs during the first two days. However, the authors conclude that laparoscopic intervention reduces the need for epidural and subsequent analgesic prescriptions compared to open surgery, thereby lowering healthcare costs. This paper is centrally about endometriosis — specifically assessing pain management protocols following laparoscopic excision of endometriotic lesions.

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Abstract

AbstractAim: 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 department of Anesthesia, Anugrah Narayan MagadhMedical College and Hospital, Gaya, India for 15 months and 100 patients were included inthe study.Results: Majority of the patients (26%) were belonged to overweight (25.00–29.99) categoryfollowed by 24% Obesity class III (≥40). 78% cases completed ≤12 years of school and 68%were married. 66% had no analgesia followed by 32% non-opioid analgesia. Mean pain scoreswere significantly higher at one week (1.62, � < 0.0001), four weeks (0.63, � = 0.02), and sixmonths (0.27, � = 0.04), but not at three months following surgery. During the first twopostoperative 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 endometrial canceris associated with less need for epidural and postoperative analgesic prescription comparedwith open surgery, saving on costs of analgesia and highlighting a further significant benefit topatients and the healthcare system of laparoscopic treatment over traditional open abdominalsurgery
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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 department of Anesthesia, Anugrah Narayan Magadh Medical College and Hospital, Gaya, India for 15 months and 100 patients were included in the study.

Results

Majority of the patients (26%) were belonged to overweight (25.00–29.99) category followed by 24% Obesity class III (≥40). 78% cases completed ≤12 years of school and 68% were married. 66% 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)

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 department of Anesthesia, Anugrah Narayan Magadh Medical College and Hospital, Gaya, India for 15 months and 100 patients were included in the study.

Results

Majority of the patients (26%) were belonged to overweight (25.00–29.99) category followed by 24% Obesity class III (≥40). 78% cases completed ≤12 years of school and 68% were married. 66% 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,Issue5,Article64.pdf Files (373.4 kB) | Name | Size | Download all | |---|---|---| | md5:f202d1b67e8ad77a68a9928f76c1e773 | 373.4 kB | Preview Download | Additional details Dates - Accepted - 2023-03-19

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