title: Preemptive epidural analgesia for thoracic surgery.
abstract: The purpose of this study was to determine if preemptive epidural analgesia performed before thoracotomy incision and during the operation reduces postoperative pain. Patients in the treatment group received 8 mL of 0.25% bupivacaine and 2 mL of fentanyl (50 microg/mL) via the epidural route prior to skin incision, followed by an infusion of bupivacaine 0.1% and fentanyl 10 microg/mL at 6 mL/hr. The control group received saline in the epidural. All patients in both groups were dosed with 8 mL of 0.25% bupivacaine and 2 mL of fentanyl 50 microg/mL via the epidural route at the time of the chest closure. The patients in the treatment group required less isoflurane intraoperatively and had lower maximum pain scores in the first 6 hours postoperatively. No significant differences were noted after the first 6 hours.
authors.affiliation: Department of Anesthesiology, Box 1010, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Neustein
authors.forename: Joel M
authors.initials: JM
authors.lastname: Kreitzer
authors.forename: Daniel
authors.initials: D
authors.lastname: Krellenstein
authors.forename: David L
authors.initials: DL
authors.lastname: Reich
authors.forename: Eugene
authors.initials: E
authors.lastname: Rapaport
authors.forename: Edmond
authors.initials: E
authors.lastname: Cohen
mesh_terms: D015360:Analgesia, Epidural / Q000379:methods*; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D004311:Double-Blind Method; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011300:Preoperative Care; D013908:Thoracotomy
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine