Postoperative pain and pulmonary complications: Comparison of three analgesic regimens

Abstract

Abstract In a prospective study, patients undergoing cholecystectomy were randomly allocated to receive (a) intermittent intramuscular morphine (n = 25), (b) continuous intravenous morphine infusion (n = 25) or (c) epidural bupivacaine (n = 25) for postoperative pain relief. Morphine by intravenous infusion provided comparable pain relief to intermittent intramuscular morphine; there was no significant difference in the incidence of postoperative pulmonary complications. Patients receiving epidural bupivacaine for 12 h had better analgesia than patients receiving morphine (P <0.001). Arterial oxygen tensions were also significantly higher in the epidural group for the first three postoperative days (P <0.05). Epidural analgesia was associated with a significant reduction in the incidence of pulmonary complications (P <0.01) and chest infection (P <0.05).