Addition of lumbar intrathecal morphine along with standard thoracic epidural anesthesia for abdomino thoracic esophagectomy

Abstract

Introduction: Thoracic epidural anaesthesia (TEA) has been the standard of care for postoperative pain management for patients undergoing abdomino-thoracic esophagectomy. The study aims to observe whether addition of lumbar intrathecal morphine along with TEA reduces the post operative pain scores, post operative opioid consumption and total epidural drug requirement. Materials and methods:50 patients divided into two groups, one group was given standard TEA at level T5-T7, other group was receiving intrathecal morphine along with TEA. General anaesthesia will be provided as per standard protocol and one lung isolation will be achieved using Robertsons double lumen tube of proper size. Pain scores will be monitored using Numerical rating Scale. Total requirement of epidural drug in both the groups , requirement of rescue analgesia, complications in both the groups will be observed. Results and observations: In our study we found that VAS score were better in the combined intrathecal morphine plus thoracic intrathecal morphine plus thoracic epidural approach group and there were less need of rescue analgesia and good recovery compared to conventional thoracic epidural approach. Haemodynamic parameters and complications were almost comparable in both the groups except for heart rate.