Early postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural analgesia: a randomised study


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yeğin a., Erdogen A., kayacan n., karslı b.

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, cilt.24, sa.3, ss.420-424, 2003 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 24 Sayı: 3
  • Basım Tarihi: 2003
  • Doi Numarası: 10.1016/s1010-7940(03)00345-2
  • Dergi Adı: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.420-424
  • Anahtar Kelimeler: analgesia, epidural, thoracotomy, pain, postoperative, PREEMPTIVE ANALGESIA, BUPIVACAINE, MORPHINE, FENTANYL
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Objectives: Effective analgesia and blockade of the perioperative stress response may improve outcome and epidural analgesia plays a role in the reduction of pulmonary complications following thoracic surgery. In this study, we assessed preoperative and postoperative thoracic epidural analgesia (Preop-TEA and Postop-TEA) techniques on post-thoracotomy pain in 61 patients undergoing posterolateral thoracotomy. Methods: A thoracic epidural catheter was inserted into all the patients before surgery. In Group I, 8 mL of 0.25% bupivacame plus fentanyl 50 mug in 2 mL was administered preoperatively. In Group 11, no medication was administered via the epidural catheter preoperatively and intraoperatively. Postoperative analgesia was maintained with patient-controlled epidural analgesia with bupivacaine and fentanyl solution in both groups. Pain was evaluated at 2, 4, 8, 12, 24 and 48 h at rest and coughing. Results: Preop-TEA Group was associated with decreased pain compared with the Postop-TEA Group. Conclusions: In conclusion, preoperative epidural analgesia is an appropriate method for post-thoracotomy pain and is more effective in preventing acute postoperative pain. (C) 2003 Elsevier B.V. All rights reserved.