General anaesthesia

• total intravenous anaesthesia with propofol 5-10 mg / kg / h,
• remifentanil 0.1 to 0.3 micrograms / kg / min and muscle relaxation with cis-atracurium
• use of a bispectral index
• monitoring with a target range of 40-60
• at the end of the anaesthesia all patients get 0.1 mg / kg morphine intravenously epidural catheter
• plant of the epidural catheter under sterile conditions at the intervertebral space of the vertebral body 8-10 of the thoracic spine• local anaesthesia with lidocaine 1%
• puncture with a Tuohy 18 G- needle, Lost of resistance technique
• after a negative test dose with bupivacaine 0,5% isobar we inject fractional ropivacaine 10 ml 0,2%, after that continuous administration of ropivacaine 0,2% via patient-controlled-analgesia-device with a sweep rate of 6 ml/h, all Patients also receive an intravenous morphine-patient-controlled-analgesia-device

General anesthesia

• anesthesia with propofol 5-10 mg / kg / h, remifentanil 0.1 to 0.3 micrograms / kg / min and muscle relaxation with cis-atracurium
• Bispektralindex monitoring with a target range of 40-60
• at the end of the anesthesia all patients get 0.1 mg / kg morphine intravenously Transversus abdominis plane blockade
• ultrasound visible needles, a special pin detection software
• under visual control the needle moves into the space between Musculus obliquus internus and M. transversus abdominis
• Under sonographic control we inject a local anesthetic depot (30 ml of ropivacaine 0.375%)
• puncture is performed under constant protective nerve stimulation with a current of 1 mA, pulse duration 0.1 ms, frequency 2 Hz All Patients receive an i.v. Morphine-patient-controlled-analgesia-device

General anaesthesia

• total intravenous anesthesia with propofol 5-10 mg / kg / h, remifentanil 0.1 to 0.3 micrograms / kg / min and muscle relaxation with cis-atracurium
• we use a of BIS monitoring with a target range of 40-60
• at the end of the aneasthesia all patients get 0.1 mg / kg morphine intravenously intravenous pain therapy with
• Morphine-patient-controlled-analgesia-device

Bilateral one time injection of local anaesthetic in the space between the transversus abdominis muscle and obliquus internus muscle preoperatively. Follow up for three days.

Pain in rest in the op-area during the first 3 days

opioidconsumption during the first 3 days

Pain in the op-area in motion during the first three days