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391. Postoperative analgesia with double epidural catheter versus single epidural catheter after lower limb free flap reconstruction

Methods: Thirty six patients aged between 18-51 years were included in this study. Single epidural catheter was placed at L3-L4 in 21 patients (group 1). In 15 patients (group 2), double epidural catheters were placed at L3-L4 and T6-T7 levels. Ten mL boli of bupivacaine 0.25% were given through each epidural catheter. Then, continuous infusion of bupivacaine 0.1% and morphine 0.1 mg/mL were started at 4-8 mL /h into the lower catheter and at 3-5 mL/h into the upper catheter until the end of surgery. For postoperative analgesia, patient controlled analgesia was provided through lumbar epidural catheters. In addition, infusion of morphine 0.1 mg/mL at 2-3 mL/h was administered through torasic epidural catheter in group 2. Postoperative pain was assessed at 2, 6, 12, 24, 48 h using visual analogue score (VAS). Intravenous morphine of 2 mg was administered as a rescue analgesic if VAS exceeded 3. Pain scores, rescue morphine consumption, patient’s satisfaction and adverse effects were recorded. Demographic data, rescue morphine consumption, VAS values and patient’s satisfaction were analyzed using the Mann-Whitney test. P value 0.05 was considered significant.