title: Perioperative analgesia in pulmonary surgery.
abstract: OBJECTIVE
  In pulmonary surgery many studies have shown how pain associated with residual doses of anaesthetic drugs can cause a decrease in pulmonary volumes and depression of the cough reflex. Both these phenomena are responsible for a rising incidence of postoperative mortality and morbidity. The most widely used postoperative analgesic techniques are continuous systemic analgesia and epidural analgesia. The aim of this study is to verify the advantages and the disadvantages of both analgesic techniques.
  
  
  METHODS
  Fifty patients, undergoing pulmonary surgery, were recruited and divided, after randomization into 2 groups. Patients included in A group received an epidural administration of naropina 0.2%+fentanyl 4 microg/mL by elastomeric pump (rate 5 ml/h). Patients included in B group received an ev continuous infusion of tramadol 600 mg+ketorolac trometamina 120 mg+ranitidina 200 mg+ondansetron 16 mg by elastomeric pump (rate 5 ml/h for 48 hours).
  
  
  RESULTS
  Both groups showed good analgesic effects. Pain rest relief was between 3 and 1.7 points in group B and between 2.5 and 0.4 points in group A. Incident pain was 4.8 at awakening time and it decreased to 4 after 48 hours in group B while in group A it was from 3.2 to 1.8 in the same period of B group.
  
  
  CONCLUSIONS
  Our data show that both analgesic techniques are able to guarantee a good rest pain relief after thoracotomy. Epidural analgesia showed more efficacy as far as incident pain relief but it was more difficult to realise and it showed less acceptance by patients.
authors.affiliation: Pain Therapy Unit, University of Genoa, Genoa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Palermo
authors.forename: P
authors.initials: P
authors.lastname: Gastaldo
authors.forename: P
authors.initials: P
authors.lastname: Malerbi
authors.forename: G
authors.initials: G
authors.lastname: Benvegnù
authors.forename: S
authors.initials: S
authors.lastname: Nicoscia
authors.forename: C
authors.initials: C
authors.lastname: Launo
mesh_terms: D000368:Aged; D000758:Anesthesia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D019990:Perioperative Care; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D013510:Pulmonary Surgical Procedures