Sufentanil vs morgina in associazione alla ropivacaina per l'analgesia epidurale toracica in chirurgia addominale maggiore.

BACKGROUND: Pain, postoperative ileus, nausea, vomiting are the universal complications after major abdominal surgery. The aim of this study was to assess pain relief, side effects and recovery of gastrointestinal function during epidural analgesia with ropivacaine plus sufentanil and ropivacaine plus morphine after major abdominal surgery. METHODS: In this prospective study, sixty patients (median age 62+/-12 years) undergoing major abdominal surgery, after informed consent, were randomized into two groups, during a period of 3 months. Patients who were not considered suitable candidates for epidural anaesthesia were excluded. Epidural catheters were inserted at T8-T9 (upper abdominal surgery) or T9-T11 (lower abdominal surgery) and ropivacaine 0,5% 7-9 ml (upper abdominal surgery) or 10-12 ml (lower abdominal surgery) combined with sufentanil 30 mcg (group S, n=30) or with morphine 2 mg (group M, n=30) was injected. General anaesthesia was induced and a continuous epidural infusion of ropivacaine 0.5% 5-10 ml/h was begun. Postoperatively, continuous epidural administration of ropivacaine 0.2% plus sufentanil 0.5 mcg/ml (group S) or ropivacaine 0.2 plus morphine 0.02 mg/ml (group M) was continued. Data on the quality of analgesia, recovery of gastrointestinal function and all side effects were recorded for 48 hours. RESULTS: Incident and resting pain scores were not significantly different among group; although sufentanil provided better resting pain scores at 16th, 20th, 24th hours, and incident pain score at 24th hour. The incidence of nausea, vomiting and pruritus was more in morphine group (p