title: Comparison of short-term versus long-term epidural analgesia after limited thoracotomy with special reference to pain score, pulmonary function, and respiratory muscle strength.
abstract: To determine the optimal duration of epidural analgesia (EA) after lung cancer surgery, a retrospective analysis was conducted to compare chest pain, pulmonary function, and respiratory muscle strength between patients given EA until postoperative day (POD) 3 and those given EA until POD 8. Each group comprised 25 lung cancer patients who underwent a lobectomy under anterior limited thoracotomy and given continuous thoracic EA using morphine until POD 3 (POD3-EA group) or POD 8 (POD8-EA group). The two groups were matched by sex and age. Postoperative pain from PODs 1 to 12 was evaluated by the pain score and analgesic requirements. The pulmonary function and respiratory muscle strength were measured on POD 7. The POD3-EA group did not experience any increase in pain after withdrawal, but the POD8-EA group did show a significant increase in pain the day after withdrawal (P < 0.05). The pain scores on PODs 8 and 9 in the POD8-EA group were significantly higher than those in the POD3-EA group (P < 0.05). There was no significant difference in pulmonary function and respiratory muscle strength on POD 7 between the two groups. Although the postoperative thoracic EA did not affect pulmonary function and respiratory muscle strength, prolonged thoracic EA after a limited thoracotomy significantly increased the pain after withdrawal, thus negatively affecting postoperative pain control.
authors.affiliation: Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nomori
authors.forename: H
authors.initials: H
authors.lastname: Horio
authors.forename: K
authors.initials: K
authors.lastname: Suemasu
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008175:Lung Neoplasms / Q000601:surgery*; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011013:Pneumonectomy; D012132:Respiratory Muscles / Q000187:drug effects*; D013908:Thoracotomy
chemical_list: D009020:Morphine