title: Epidural ropivacaine or sufentanil-ropivacaine infusions for post-thoracotomy pain.
abstract: OBJECTIVE
  The aim of this study was to compare the analgesic efficacy and side effects of continuous epidural infusions of ropivacaine and ropivacaine-sufentanil mixtures after thoracotomy.
  
  
  METHODS
  Sixty-two patients scheduled for thoracic surgery were allocated in this prospective double-blinded randomised study. They received an epidural catheter inserted from thoracic 5-6 (Th(5-6)) interspace a day before surgery and were randomly assigned into two groups, sufentanil-ropivacaine group (Group SR, n=31) and ropivacaine group (Group R, n=31). Bolus dose of the study drugs, ropivacaine 0.2% or ropivacaine 0.2% and sufentanil 0.75 microg/ml calculated in ml according to the patient's height was given through the epidural catheter before surgery. One hour after anaesthesia induction, another bolus was given and the epidural infusion was started (4.5-8 ml). Whenever visual analogue scale (VAS) scores were > or =4 during function, the patients received additional boluses and the infusion rate was increased by 1 ml/h. If the pain was not relieved after administration of two boluses, the patient was excluded from the study.
  
  
  RESULTS
  VAS at rest and during function was lower in ropivacaine-sufentanil group and the need for additional boluses and infusion rate increase was high in ropivacaine group (P<0.05). Ropivacaine-sufentanil infusion rate was decreased due to nausea and vomiting in two patients and due to CO(2) retention in one patient. There was no statistically significant difference between the incidences of side effects except pruritus significantly higher in Group SR. The total epidural solution volume was more in Group R (P<0.05).
  
  
  CONCLUSIONS
  The continuous epidural infusion of ropivacaine with sufentanil provided superior pain relief than ropivacaine alone without causing any severe side effect or post-operative pulmonary impairment.
authors.affiliation: Department of Anaesthesiology, Ankara Oncology Hospital, Ankara, Turkey. goncatuncel@hotmail.com
authors.forename: Gonca
authors.initials: G
authors.lastname: Tuncel
authors.forename: Gulcin
authors.initials: G
authors.lastname: Ozalp
authors.forename: Serpil
authors.initials: S
authors.lastname: Savli
authors.forename: Ozgur
authors.initials: O
authors.lastname: Canoler
authors.forename: Mensure
authors.initials: M
authors.lastname: Kaya
authors.forename: Nihal
authors.initials: N
authors.lastname: Kadiogullari
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D000077212:Ropivacaine; D018709:Statistics, Nonparametric; D017409:Sufentanil / Q000008:administration & dosage*; D013908:Thoracotomy; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000077212:Ropivacaine; D017409:Sufentanil