title: Early postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural analgesia: a randomised study.
abstract: OBJECTIVE
  Effective analgesia and blockade of the perioperative stress response may improve outcome and epidural analgesia plays a role in the reduction of pulmonary complications following thoracic surgery. In this study, we assessed preoperative and postoperative thoracic epidural analgesia (Preop-TEA and Postop-TEA) techniques on post-thoracotomy pain in 61 patients undergoing posterolateral thoracotomy.
  
  
  METHODS
  A thoracic epidural catheter was inserted into all the patients before surgery. In Group I, 8 mL of 0.25% bupivacaine plus fentanyl 50 microg in 2 mL was administered preoperatively. In Group II, no medication was administered via the epidural catheter preoperatively and intraoperatively. Postoperative analgesia was maintained with patient-controlled epidural analgesia with bupivacaine and fentanyl solution in both groups. Pain was evaluated at 2, 4, 8, 12, 24 and 48 h at rest and coughing.
  
  
  RESULTS
  Preop-TEA Group was associated with decreased pain compared with the Postop-TEA Group.
  
  
  CONCLUSIONS
  In conclusion, preoperative epidural analgesia is an appropriate method for post-thoracotomy pain and is more effective in preventing acute postoperative pain.
authors.affiliation: Department of Anaesthesiology, Akdeniz University Medical Faculty, Antalya, Turkey. ayegin@ixir.com
authors.forename: Arif
authors.initials: A
authors.lastname: Yegin
authors.forename: Abdullah
authors.initials: A
authors.lastname: Erdogan
authors.forename: Nurten
authors.initials: N
authors.lastname: Kayacan
authors.forename: Bilge
authors.initials: B
authors.lastname: Karsli
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000704:Analysis of Variance; D002045:Bupivacaine / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D013908:Thoracotomy
chemical_list: D005283:Fentanyl; D002045:Bupivacaine