Epidural anaesthesia as a method of pre‐emptive analgesia for abdominal hysterectomy

Summary The effect of pre- versus postincisional epidural blockade without the use of systemic opioids wasinvestigated in a randomised, double-blind study of two groups of 25 patients undergoingabdominal hysterectomy performed under general anaesthesia. The first group received, via alumbar epidural catheter, 0.9% saline (16ml) 15min prior to surgical incision and 0.5%bupivacaine (15ml) and fentanyl 50mg (1ml) 15min prior to skin closure. The second group of25 patients received the same amount of bupivacaine and fentanyl 15min pre-incision and salineprior to skin closure. Visual analogue pain scores and patient-controlled morphine consumptionwere measured at specified times for 48h. We were unable to detect any significant difference ineither of the outcome measures for the two groups and thus were unable to demonstrate thatepidural blockade using local anaesthetic and opioid has a pre-emptive effect. Keywords Pain ; postoperative analgesia. Anaesthetic techniques , regional ; epidural, pre-emptive.