title: Patient-controlled epidural analgesia after thoracic and upper abdominal surgery using sufentanil with and without bupivacaine 0.125%.
abstract: BACKGROUND
  Epidural sufentanil can relieve postoperative pain after thoracic and upper abdominal surgery but it has some unwanted side effects. Patient-controlled epidural analgesia (PCEA) allows patients to titrate and reduce their analgesic requirements.
  
  
  OBJECTIVE
  The study aims to assess the use of demand-only PCEA after thoracotomy and upper abdominal surgery using sufentanil with or without bupivacaine in terms of pain control, amount of analgesic required and side effect profile.
  
  
  METHODS
  After the Hospital Ethics Committee approval and written informed consent, 34 ASA I and II patients were enrolled in this prospective, randomised, double-blinded controlled study. Post-operatively, after achieving adequate analgesia in the recovery, the patients were randomised to receive either sufentanil 1 microg/ml in normal saline (Group S) or sufentanil 1 microg/ml with bupivacaine 0.125% (Group SB) in a demand-only PCEA programme. Pain scores, side effects and amount of analgesia used were reviewed every hour.
  
  
  RESULTS
  The demographic profile of both groups was similar. The amount of sufentanil used was higher in Group S than in Group SB but it was not statistically significant. The numbers of patients with high pain scores at rest and during movement were not significantly different between the two groups. The side effect profiles of both groups were similar.
  
  
  CONCLUSIONS
  The PCEA demand-only programme using sufentanil 1 microg/ml with and without bupivacaine 0.125% was satisfactory after thoracotomy and upper abdominal surgery in our patient population. The addition of bupivacaine to sufentanil did not significantly reduce the amount of sufentanil required, the pain scores or the side effects.
authors.affiliation: Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Outram Road, Singapore 169608. rumini@bigfoot.com
authors.forename: R
authors.initials: R
authors.lastname: Poopalalingam
authors.forename: M Y H
authors.initials: MY
authors.lastname: Chow
authors.forename: L T
authors.initials: LT
authors.lastname: Wong
mesh_terms: D000005:Abdomen / Q000601:surgery*; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002045:Bupivacaine; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies; D017409:Sufentanil; D013908:Thoracotomy
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D017409:Sufentanil; D002045:Bupivacaine