Postoperative pain treatment after cholecystectomy with epidural sufentanil at lumbar or thoracic level.
The difference in analgesic activity following lumbar (group I) or thoracic (group II) epidural administration of 50 micrograms sufentanil was studied after cholecystectomy. Fifteen patients in each group were evaluated for pain relief using a linear analog scale (LAS), heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume (FEV1) and arterial CO2 tension (PaCO2). In five additional patients in each group 75 micrograms sufentanil was injected for determination of serum levels. Pain scores were lower than three in both groups after 10 min, while mean pain scores remained below one from 20 min until 2 h following injection in both groups. Satisfactory pain relief lasted for 4 h. RR was significantly decreased from two until 360 min. in the lumbar group and from five until 120 min in the thoracic group. PaCO2 was raised in both groups only during the first hour. PEF and FVC were significantly improved compared to control 1, 2 and 4 h following injection. Serum sufentanil levels reached a maximum of 0.299 +/- 0.052 ng.ml-1 in the lumbar group and 0.377 +/- 0.076 ng.ml-1 in the thoracic group after 5 min. There were no significant differences between the two groups in the variables studied.
Department of Anaesthesiology, Flemish Free University of Brussels, Belgium.
C
C
Verborgh
M
M
Claeys
C
C
Vanlersberghe
F
F
Camu
D000368:Aged; D015360:Analgesia, Epidural; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D002763:Cholecystectomy / Q000009:adverse effects*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D012119:Respiration / Q000187:drug effects; D017409:Sufentanil / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D013904:Thoracic Vertebrae; D014797:Vital Capacity / Q000187:drug effects
D002245:Carbon Dioxide; D017409:Sufentanil