title: Clinical study of patient-controlled epidural analgesia with tetracaine hydrochloride after pulmonary lobectomy.
abstract: OBJECTIVE
  To investigate the efficacy and safety of tetracaine hydrochloride in patient-controlled epidural analgesia (PCEA) after pulmonary lobectomy.
  
  
  METHODS
  Forty-three patients scheduled for elective pulmonary lobectomy under general anesthesia were randomly allocated into either tetracaine group (22 patients) or ropivacaine group (21 patients). In the tetracaine group, 0.15% tetracaine was used for postoperative PCEA, while 0.3% ropivacaine was used in the ropivacaine group. The duration of postoperative analgesia was 48 h. The PCEA included a bolus of 6 ml with a lockout time of 1 h. Postoperative pain score was measured by visa analogue scale (VAS). Forced expired volume at the 1st second (FEV1.0), forced vital capacity (FVC), FEV1.0/FVC and peak expired flow (PEF) were measured preoperatively and daily after surgery. Hemodynamics were monitored and recorded before and after each administration of local anesthetics during the period of the study.
  
  
  RESULTS
  VAS scores in both groups decreased significantly after a bolus injection of local anesthetics. There was no significant difference between the two groups in VAS either before or after the administration of PCEA. On the 1st and 2nd days after the operation, pulmonary function was reduced in both groups. However, there were no significant differences between the percentage of the changes of FEV1.0, FEV1.0/FVC and PEF in the two groups. There were also significant differences between the percentage of the changes of heart rate, mean arterial blood pressure and SpO2 after administration of local anesthetics. There was no significant difference in overall satisfaction with pain relief.
  
  
  CONCLUSIONS
  The analgesic effect of 0.15% tetracaine is similar to that of 0.3% ropivacaine used in patient-controlled epidural analgesia after thoracotomy. No serious side effects were observed.
authors.affiliation: Department of Anesthesiology, Peking Union Medical College Hospital, Beijing 100730.
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Guo
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.forename: Tiehu
authors.initials: T
authors.lastname: Ye
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Ren
authors.forename: Yuguang
authors.initials: Y
authors.lastname: Huang
authors.forename: Ailun
authors.initials: A
authors.lastname: Luo
mesh_terms: D000293:Adolescent; D000328:Adult; D000577:Amides / Q000627:therapeutic use; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000779:Anesthetics, Local / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011013:Pneumonectomy; D000077212:Ropivacaine; D013748:Tetracaine / Q000627:therapeutic use*
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D013748:Tetracaine; D000077212:Ropivacaine