Opioid Sparing Effect of Thoracic Epidural Analgesia for Open Upper Abdominal Surgery
Hepatoma, Pancreas Cancer
About this trial
This is an interventional treatment trial for Hepatoma focused on measuring open upper abdominal surgery, continuous epidural analgesia
Eligibility Criteria
Inclusion Criteria:
- age 18-80 years
- open upper abdominal surgery
- American Society of Anesthesiologists (ASA) grade I-III
Exclusion Criteria:
- contraindications to CEA
- inability communication
- patient's refusal
- emergency surgery
- BMI > 35
Sites / Locations
- Faculty of Medicine Siriraj Hospital, Mahidol University
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Thoracic continuous epidural analgesia
No CEA
Thoracic continuous epidural analgesia at T7-8 or T8-9 combined with IV PCA fentanyl (bolus mode only 15 ug/bolus, 5 minutes lockout, 4 hours limit 200 ug). Multimodal analgesia Intraoperative : thoracic epidural infusion with 0.0625% bupivacaine with morphine 0.02 ug/ml 5 ml/h, morphine 2 mg epidurally are given. Postoperative: 0.0625% bupivacaine with morphine 0.02 ug/ml 5 ml/h is given combined with IV patient-controlled analgesia; bolus mode only, fentanyl 15 ug/bolus, lockout interval 5 minutes, 4 hours limit 200ug, multimodal analgesia: paracetamol 1000 mg iv every 6 hours until patient can take orally, change to 1000 mg orally every 6 hours total 3 days, Parecoxib 40 mg IV x 4 doses then COX2 inhibitor (etoricoxib 90 mg orally x2 days)
IV PCA fentanyl, IV patient-controlled analgesia; bolus mode only, fentanyl 15 ug/bolus, lockout interval 5 minutes, 4 hours limit 200ug multimodal analgesia: paracetamol 1000 mg IV every 6 hours until patient can take orally, change to 1000 mg orally q 6 hours total 3 days, Parecoxib 40 mg IV x 4 doses then COX2 inhibitor (Etoricoxib 90 mg orally x2 days)