Programmed Intermittent Bolus Dosing Versus Continuous Epidural Infusion for Epidural Analgesia in Abdominal Surgery.
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 12/12/2018 |
| Start Date: | April 14, 2016 |
| End Date: | April 30, 2019 |
| Contact: | Matthias Behrends, MD |
| Email: | matthias.behrends@ucsf.edu |
A Prospective, Randomized Analysis of Epidural Anesthesia Using Programmed Intermittent Epidural Boluses Versus Continuous Epidural Infusion in Patients Undergoing Abdominal Surgery.
Epidurals are an effective means for providing neuraxial anesthesia and analgesia. Prior
studies in labor epidurals have demonstrated that a programmed intermittent bolus application
of local anesthesia can improve pain control by reducing the amount of local anesthetic
required as well as improve patient satisfaction when compared to continuous epidural
infusions. The effects of programmed intermittent bolus of epidural local anesthetics
compared to continuous epidural infusions in a surgical setting have yet to be elucidated.
Our goal is to evaluate the use of programmed intermittent bolus compared to continuous
epidural infusion in a surgical patient population. We plan to enroll patients already
undergoing abdominal surgeries including colorectal, gynecologic, surgical oncology,
urological where epidural anesthesia can be employed. The primary endpoints of the study will
be the total local anesthetic consumption and total opioid consumption as surrogate markers
for the quality of epidural anesthesia. Secondary endpoints are pain scores and functional
measurements, patient satisfaction, and incidence of hypotension.
studies in labor epidurals have demonstrated that a programmed intermittent bolus application
of local anesthesia can improve pain control by reducing the amount of local anesthetic
required as well as improve patient satisfaction when compared to continuous epidural
infusions. The effects of programmed intermittent bolus of epidural local anesthetics
compared to continuous epidural infusions in a surgical setting have yet to be elucidated.
Our goal is to evaluate the use of programmed intermittent bolus compared to continuous
epidural infusion in a surgical patient population. We plan to enroll patients already
undergoing abdominal surgeries including colorectal, gynecologic, surgical oncology,
urological where epidural anesthesia can be employed. The primary endpoints of the study will
be the total local anesthetic consumption and total opioid consumption as surrogate markers
for the quality of epidural anesthesia. Secondary endpoints are pain scores and functional
measurements, patient satisfaction, and incidence of hypotension.
See brief summary
Inclusion Criteria:
- American Society of Anesthesia physical classification I - III, scheduled for surgery
with anticipated an epidural anesthesia (including but not limited to colorectal,
surgical oncology, urology, gynecology) as part of their perioperative treatment
Exclusion Criteria:
- Age younger than 18 years of age, non-English speaking, contraindication for neuraxial
anesthesia (such as, but not limited to coagulopathy, infection at site, allergy to
local anesthetic), preexisting neurologic deficits, inability to consent due to
cognitive dysfunction, patients with pain numeric rating score > 5 each day for
greater than 3 months, daily opioid consumption > 100 oral morphine equivalents for 14
consecutive days prior to surgery, patient refusal.
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