PREOPERATIVE SPINAL BUPIVACAINE DOES NOT REDUCE POSTOPERATIVE MORPHINE REQUIREMENT IN WOMEN UNDERGOING TOTAL ABDOMINAL HYSTERECTOMY

Background and Objectives. This study was undertaken to determine whet her preoperative spinal anesthesia with local anesthetics would exert a pre-emptive effect on postoperative analgesia by reducing neural aff erent stimulation. Methods. The authors studied 38 healthy women under going total abdominal hysterectomy. Patients were randomly allocated t o two groups: group A received a spinal block (T3-S5) prior to inducti on of anesthesia and surgery, while in group B the block was performed after surgery prior to extubation of the trachea. Patient-controlled analgesia morphine was administered to both groups during the first 24 postoperative hours. Results. Pain and sedation scores at 6, 12, and 24 hours were similar in the two groups. Cumulative morphine consumpti on at 6 and 24 hours after surgery was similar in both groups; however at 12 hours more morphine was needed in group A (P < .02). Conclusion s. The authors were unable to demonstrate that spinal block with bupiv acaine before surgery, as opposed to after surgery, decreased the requ irement of morphine in the postoperative period.