title: Effect of patient-controlled epidural analgesia for pain relief after thymectomy in patients with myasthenia gravis.
abstract: OBJECTIVE
  To evaluate the effect of patient-controlled epidural analgesia (PCEA) with ropivacaine or bupivacaine in relieving pain after thymectomy in patients with myasthenia gravis.
  
  
  METHODS
  Twenty adult ASA I-II patients with myasthenia gravis were randomized to receive either 0.125% ropivacaine (Group R, n=10) or 0.125% bupivacaine (Group B, n=10) with a PCEA device after transsternal thymectomy. PCEA (continuous infusion at 1 ml/h, bolus dose of 4 ml and lockout time of 30 min) was implemented via an epidural catheter inserted in the T3-4 intervertebral space. The vital signs and visual analogue scale (VAS), together with cumulative consumption (CC) of ropivacaine or bupivacaine were recorded within 48 h postoperatively.
  
  
  RESULTS
  The vital signs, including systolic and diastolic blood pressure, heart rate, SpO2, pH and PaCO2, did not show any significant differences between the 2 groups. The CC of the local anesthetic was significantly higher in group R than that in group B at 24 and 48 h postoperatively, but VAS were not significantly different between the 2 groups which was less than 4 in both groups.
  
  
  CONCLUSIONS
  PCEA with low concentration of ropivacaine or bupivacaine may provide effective and safe analgesia after transsternal thymectomy.
authors.affiliation: Department of Anesthesiology, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China.
authors.forename: Ji-Can
authors.initials: JC
authors.lastname: Lu
authors.forename: Chun-Shui
authors.initials: CS
authors.lastname: Lin
authors.forename: Shi-Wei
authors.initials: SW
authors.lastname: Liang
authors.forename: Jin-Fang
authors.initials: JF
authors.lastname: Xiao
authors.forename: Miao-Ning
authors.initials: MN
authors.lastname: Gu
mesh_terms: D000328:Adult; D000577:Amides / Q000627:therapeutic use; D015360:Analgesia, Epidural / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D002045:Bupivacaine / Q000627:therapeutic use; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000503:physiopathology / Q000601:surgery*; D010100:Oxygen / Q000097:blood; D010146:Pain / Q000517:prevention & control*; D011312:Pressure; D000077212:Ropivacaine; D013934:Thymectomy; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D002245:Carbon Dioxide; D000077212:Ropivacaine; D010100:Oxygen; D002045:Bupivacaine