Pflug 1974.
| Methods | RCT Informed consent obtained from each participant before the operation Funding: governmental |
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| Participants | 40 patients scheduled for upper abdominal (n = 24) or hip fracture surgery (n = 16) were studied for 72 hours Inclusion criteria included absence of hypoxaemia, normal chest x‐ray, ambulatory before illness and no uncontrolled systemic disease We retained participants undergoing abdominal surgery only (n = 24) |
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| Interventions |
Treatment group: postoperative peridural analgesia with (n = 8) or without pulmonary therapy (n = 5). Catheters were inserted at T10‐T11 under general anaesthesia, and an infusion of bupivacaine 0.5% (day of surgery) followed by bupivacaine 0.25% (thereafter) was started in the post‐anaesthesia care unit at 3 to 5 mL/h (6 to 8 dermatoma) for 72 hours. Concentrations were adjusted to allow walking and coughing without discomfort Control group: IM morphine analgesia (10 to 15 mg every 3 to 6 hours; participants comfortable but not obtunded) with (n = 5) or without pulmonary therapy (n = 6) All participants received general anaesthesia with nitrous oxide, halothane 0.5% to 1.5% and neuromuscular blocking agents. No prophylactic antibiotics given. Pain not measured |
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| Outcomes | Hospital LOS | |
| Notes | Study authors contacted 24 February 2016, but did not reply | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | "random selection according to a table of random numbers" |
| Allocation concealment (selection bias) | Unclear risk | Not mentioned |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Not mentioned; no catheters in the IM group |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not mentioned |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | No loss to follow‐up |
| Selective reporting (reporting bias) | Low risk | All results mentioned in the Methods section are provided in the Results section |
| Other bias | Low risk | Groups well balanced (age 46.5 ± 4.6 vs 42.7 ± 4.9, for epidural bupivacaine and IM morphine, respectively) |