A Prospective Comparison of Methadone, Fentanyl, and Morphine for Post-laparotomy Epidural Analgesia

A Prospective Double Blind Randomized Comparison of Methadone, Fentanyl, and Morphine for Post-laparotomy Epidural Analgesia.

The current study aim is to compare between the opioids morphine, fentanyl and methadone in terms of efficacy and side effects profile when administered epidurally for pain management after laparotomies. Intravenous morphine will also be used. The outcomes of that method will be compared to those obtained using epidurally administered opioids, as this is another commonly used postoperative pain relief method.

Inclusion Criteria:

* Elective laparotomy

Exclusion Criteria:

• Subjects with diabetes mellitus, other neurological or systemic disease associated with altered sensory perception
• Illicit drug abusers
• Chronic use of pain medication
• Inability to understand consent form
• Age < 18
• Renal failure (Clcr<50 ml/min)
• Chronic use of drugs that can alter plasma levels and\or effect of the study drugs
• Corrected Q-T interval(QTc)=450msc and above
• Contra-indication for epidural catheter insertion
• Pregnancy