Effects of Epidural Bupivacaine and Epidural Morphine on Bowel Function and Pain After Hysterectomy

Abstract

A comparison was made of the effects of continuous analgesia with and intermittent on bowel function after abdominal hysterectomy. The duration of postoperative ileus was assessed as the time from the end of operation to the first postoperative passage of flatus and feces. Twenty-two patients were randomly allocated to two equal groups. An epidural morphine group received general anesthesia and for postoperative pain relief, and an epidural bupivacaine group was given combined general anesthesia and anesthesia with 0.5% intraoperatively and analgesia with 0.25% postoperatively. Epidural or was given for 42 h postoperatively. Pain intensity (visual analog scale) was low in both groups, but lower (P less than 0.05) in the group. The time to first passage of flatus was 22 +/- 16 h in the group and 56 +/- 22 h in the group (P less than 0.001). The time to first postoperative passage of feces was shorter (P less than 0.05) in the former than in the latter 57 +/- 44 h vs 92 +/- 22 h). The patients of the group started intake of oral fluids earlier (P less than 0.01) and to a greater extent (P less than 0.05) than those in the group. It is concluded that the duration of postoperative ileus after hysterectomy is shorter when is given for postoperative pain relief than when this is achieved by morphine.