[Prolonged epidural analgesia following thoracotomy. Clinical study and serum levels over five days].
Prolonged continuous epidural analgesia allows perithecal infusion with fentanyl and bupivacaine for 5 postoperative days after thoracic surgery. This study included 27 thoracotomized patients randomised into two groups: group X consisted of 15 subjects, group Y consisted of 12 subjects. Each patient received 33 micrograms/hr or fentanyl for 48 hours, associated with 0.25% bupivacaine in group X, and 0.125% bupivacaine in group Y. Over the three last days, the infusion rate of both drugs was decreased in the two groups. No significant clinical difference appeared between X and Y. No clinical respiratory depression occurred. In group Y, mean plasma bupivacaine concentrations remained significantly lower (p less than 0.05). Mean fentanyl levels did not increase beyond 0.8 ng/ml. The use of 0.125% bupivacaine improved the margin of safety but did not impair clinical analgesia in the study. This method provides good analgesia for thoracotomized patients.
Ragni
J
J
Département d'Anesthésie-Réanimation, Hôpital Sainte-Marguerite, Marseille.
Guillen
J C
JC
Augé
A
A
Bordigoni
L
L
Giudicelli
R
R
Fuentes
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000379:methods*; D002045:Bupivacaine / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D011182:Postoperative Care; D016032:Randomized Controlled Trials as Topic; D012129:Respiratory Function Tests; D013896:Thoracic Diseases / Q000601:surgery; D013908:Thoracotomy
D005283:Fentanyl; D002045:Bupivacaine