Serial peak expiratory flow rates in patients undergoing upper abdominal surgeries under general anaesthesia and thoracic epidural analgesia

Julie C R Misquith, Rammoorthi Rao, Karl Sa Ribeiro

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Anaesthesia and upper abdominal surgeries alter lung compliance and functional residual capacity resulting from atelectasis. Upper abdominal surgeries also cause a decrease in peak expiratory flow rates, cough reflex due to pain limited inspiration. Aim: This study aimed to study the effect of thoracic epidural analgesia (TEA) on the peak expiratory flow rates in patients undergoing upper abdominal surgeries. Materials and Methods: A total of 44 patients posted for elective surgery were enrolled. Group 1 patients received GA + 0.125% bupivacaine infusion TEA and Group 2 received GA + Inj. Diclofenac sodium 50 mg slow i.v. TID for Postoperative analgesia. Haemodynamics, VAS pain score, PEFR measurements were done at 60 minutes, 24 hours, 48 hours and 4 days after surgery in both groups. ABG analysis was taken pre operatively and 24 hours after surgery. Results: The SBP and DBP values obtained at 60 minutes (p<0.016) 24 and 48 hours (p<0.001) and day 4 (p<0.02) postoperative showed highly significant difference between the two groups which indicate better haemodynamic parameters in patients receiving epidural analgesia. Postoperatively the difference in PEFR values at 60 minutes, 24 hour, 48 hour and day 4 were very highly significant. (p<0.001). Group1 had a 10.739% deficit on day 4 from its pre operative baseline value while group 2 showed a 34.825 % deficit which was very highly significant (p<0.001). The difference in VAS scores recorded at 60 minutes, 24 hours, 48 hours and day 4 post op were very highly statistically significant (p < 0.001).The ABG taken at 24 hours shows statistically significant difference with patients in group 2 showing decreased values in pCO2 and pO2 reflecting poorer ventilation and oxygenation. Conclusion: Thoracic epidural analgesia provides superior analgesia, better cough reflex as seen by better PEFR values, were haemodynamically more stable and their ABG values were better than the NSAID group.

Original languageEnglish
Pages (from-to)UC01-UC04
JournalJournal of Clinical and Diagnostic Research
Volume10
Issue number2
DOIs
Publication statusPublished - 01-02-2016

Fingerprint

Peak Expiratory Flow Rate
Epidural Analgesia
General Anesthesia
Surgery
Thorax
Flow rate
Cough
Analgesia
Hemodynamics
Reflex
Lung Compliance
Functional Residual Capacity
Pain
Pulmonary Atelectasis
Diclofenac
Bupivacaine
Non-Steroidal Anti-Inflammatory Agents
Ambulatory Surgical Procedures
Oxygenation
Ventilation

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Clinical Biochemistry

Cite this

@article{cc9d4b90f6ae4cf0bfab7ba722bfd483,
title = "Serial peak expiratory flow rates in patients undergoing upper abdominal surgeries under general anaesthesia and thoracic epidural analgesia",
abstract = "Introduction: Anaesthesia and upper abdominal surgeries alter lung compliance and functional residual capacity resulting from atelectasis. Upper abdominal surgeries also cause a decrease in peak expiratory flow rates, cough reflex due to pain limited inspiration. Aim: This study aimed to study the effect of thoracic epidural analgesia (TEA) on the peak expiratory flow rates in patients undergoing upper abdominal surgeries. Materials and Methods: A total of 44 patients posted for elective surgery were enrolled. Group 1 patients received GA + 0.125{\%} bupivacaine infusion TEA and Group 2 received GA + Inj. Diclofenac sodium 50 mg slow i.v. TID for Postoperative analgesia. Haemodynamics, VAS pain score, PEFR measurements were done at 60 minutes, 24 hours, 48 hours and 4 days after surgery in both groups. ABG analysis was taken pre operatively and 24 hours after surgery. Results: The SBP and DBP values obtained at 60 minutes (p<0.016) 24 and 48 hours (p<0.001) and day 4 (p<0.02) postoperative showed highly significant difference between the two groups which indicate better haemodynamic parameters in patients receiving epidural analgesia. Postoperatively the difference in PEFR values at 60 minutes, 24 hour, 48 hour and day 4 were very highly significant. (p<0.001). Group1 had a 10.739{\%} deficit on day 4 from its pre operative baseline value while group 2 showed a 34.825 {\%} deficit which was very highly significant (p<0.001). The difference in VAS scores recorded at 60 minutes, 24 hours, 48 hours and day 4 post op were very highly statistically significant (p < 0.001).The ABG taken at 24 hours shows statistically significant difference with patients in group 2 showing decreased values in pCO2 and pO2 reflecting poorer ventilation and oxygenation. Conclusion: Thoracic epidural analgesia provides superior analgesia, better cough reflex as seen by better PEFR values, were haemodynamically more stable and their ABG values were better than the NSAID group.",
author = "Misquith, {Julie C R} and Rammoorthi Rao and Ribeiro, {Karl Sa}",
year = "2016",
month = "2",
day = "1",
doi = "10.7860/JCDR/2016/13942.7327",
language = "English",
volume = "10",
pages = "UC01--UC04",
journal = "Journal of Clinical and Diagnostic Research",
issn = "2249-782X",
publisher = "Journal of Clinical and Diagnostic Research",
number = "2",

}

Serial peak expiratory flow rates in patients undergoing upper abdominal surgeries under general anaesthesia and thoracic epidural analgesia. / Misquith, Julie C R; Rao, Rammoorthi; Ribeiro, Karl Sa.

In: Journal of Clinical and Diagnostic Research, Vol. 10, No. 2, 01.02.2016, p. UC01-UC04.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Serial peak expiratory flow rates in patients undergoing upper abdominal surgeries under general anaesthesia and thoracic epidural analgesia

AU - Misquith, Julie C R

AU - Rao, Rammoorthi

AU - Ribeiro, Karl Sa

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Introduction: Anaesthesia and upper abdominal surgeries alter lung compliance and functional residual capacity resulting from atelectasis. Upper abdominal surgeries also cause a decrease in peak expiratory flow rates, cough reflex due to pain limited inspiration. Aim: This study aimed to study the effect of thoracic epidural analgesia (TEA) on the peak expiratory flow rates in patients undergoing upper abdominal surgeries. Materials and Methods: A total of 44 patients posted for elective surgery were enrolled. Group 1 patients received GA + 0.125% bupivacaine infusion TEA and Group 2 received GA + Inj. Diclofenac sodium 50 mg slow i.v. TID for Postoperative analgesia. Haemodynamics, VAS pain score, PEFR measurements were done at 60 minutes, 24 hours, 48 hours and 4 days after surgery in both groups. ABG analysis was taken pre operatively and 24 hours after surgery. Results: The SBP and DBP values obtained at 60 minutes (p<0.016) 24 and 48 hours (p<0.001) and day 4 (p<0.02) postoperative showed highly significant difference between the two groups which indicate better haemodynamic parameters in patients receiving epidural analgesia. Postoperatively the difference in PEFR values at 60 minutes, 24 hour, 48 hour and day 4 were very highly significant. (p<0.001). Group1 had a 10.739% deficit on day 4 from its pre operative baseline value while group 2 showed a 34.825 % deficit which was very highly significant (p<0.001). The difference in VAS scores recorded at 60 minutes, 24 hours, 48 hours and day 4 post op were very highly statistically significant (p < 0.001).The ABG taken at 24 hours shows statistically significant difference with patients in group 2 showing decreased values in pCO2 and pO2 reflecting poorer ventilation and oxygenation. Conclusion: Thoracic epidural analgesia provides superior analgesia, better cough reflex as seen by better PEFR values, were haemodynamically more stable and their ABG values were better than the NSAID group.

AB - Introduction: Anaesthesia and upper abdominal surgeries alter lung compliance and functional residual capacity resulting from atelectasis. Upper abdominal surgeries also cause a decrease in peak expiratory flow rates, cough reflex due to pain limited inspiration. Aim: This study aimed to study the effect of thoracic epidural analgesia (TEA) on the peak expiratory flow rates in patients undergoing upper abdominal surgeries. Materials and Methods: A total of 44 patients posted for elective surgery were enrolled. Group 1 patients received GA + 0.125% bupivacaine infusion TEA and Group 2 received GA + Inj. Diclofenac sodium 50 mg slow i.v. TID for Postoperative analgesia. Haemodynamics, VAS pain score, PEFR measurements were done at 60 minutes, 24 hours, 48 hours and 4 days after surgery in both groups. ABG analysis was taken pre operatively and 24 hours after surgery. Results: The SBP and DBP values obtained at 60 minutes (p<0.016) 24 and 48 hours (p<0.001) and day 4 (p<0.02) postoperative showed highly significant difference between the two groups which indicate better haemodynamic parameters in patients receiving epidural analgesia. Postoperatively the difference in PEFR values at 60 minutes, 24 hour, 48 hour and day 4 were very highly significant. (p<0.001). Group1 had a 10.739% deficit on day 4 from its pre operative baseline value while group 2 showed a 34.825 % deficit which was very highly significant (p<0.001). The difference in VAS scores recorded at 60 minutes, 24 hours, 48 hours and day 4 post op were very highly statistically significant (p < 0.001).The ABG taken at 24 hours shows statistically significant difference with patients in group 2 showing decreased values in pCO2 and pO2 reflecting poorer ventilation and oxygenation. Conclusion: Thoracic epidural analgesia provides superior analgesia, better cough reflex as seen by better PEFR values, were haemodynamically more stable and their ABG values were better than the NSAID group.

UR - http://www.scopus.com/inward/record.url?scp=84958150206&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84958150206&partnerID=8YFLogxK

U2 - 10.7860/JCDR/2016/13942.7327

DO - 10.7860/JCDR/2016/13942.7327

M3 - Article

VL - 10

SP - UC01-UC04

JO - Journal of Clinical and Diagnostic Research

JF - Journal of Clinical and Diagnostic Research

SN - 2249-782X

IS - 2

ER -