title: [Thoracic epidural and intrathecal analgesia have similar effects on pain relief and respiratory function after thoracic surgery].
abstract: OBJECTIVE
  To compare in a prospective randomized trial the effects of thoracic epidural infusions of fentanyl (F) and bupivacaine (B) to intrathecal morphine (M) and sufentanil (S) on analgesia and respiratory function following thoracotomy.
  
  
  METHODS
  55 patients undergoing an elective postero-lateral thoracotomy were randomly assigned to one of two groups: Group I (n = 27): received intrathecal S (5 microg) and M (0.5 mg) one hour before surgery. Group II (n = 28) received, after induction of anesthesia, an initial dose of 10 to 20 mL of a solution of B 0.25% and F 2 microg.mL(-1) via an epidural thoracic catheter previously inserted between T5 and T8. The same solution was infused during surgery. After surgery, patients received a continuous infusion of B 0.1% and F 2 microg.mL(-1) with a bolus every 15 min if needed. Heart rate (HR), mean arterial pressure (MAP), SpO(2), PaCO(2), respiratory rate (RR), forced expiratory volume in one second, peak expiratory flow rate and forced vital capacity were recorded at different times from the day before surgery till T48 = 48 hr after surgery. Subjective pain was assessed using a 10 cm visual analogue scale (VAS) scoring at rest and during cough.
  
  
  RESULTS
  No significant difference was noted between both groups concerning VAS, HR, MAP, SpO(2), PaCO(2) and RR. Variations of the respiratory function tests were identical in both groups.
  
  
  CONCLUSIONS
  This study shows that intrathecal M and S offer analgesia comparable to thoracic epidural infusion of B and F.
authors.affiliation: Département d'Anesthésie-Réanimation, Hôpital Hôtel-Dieu de France, Beyrouth, Liban. vix@dm.net.lb
authors.forename: Samia
authors.initials: S
authors.lastname: Madi-Jebara
authors.forename: Céline
authors.initials: C
authors.lastname: Adaimé
authors.forename: Alexandre
authors.initials: A
authors.lastname: Yazigi
authors.forename: Fadia
authors.initials: F
authors.lastname: Haddad
authors.forename: Gemma
authors.initials: G
authors.lastname: Hayek
authors.forename: Ghassan
authors.initials: G
authors.lastname: Sleilaty
authors.forename: Marie-Claire
authors.initials: MC
authors.lastname: Antakly
mesh_terms: D000698:Analgesia / Q000379:methods*; D015360:Analgesia, Epidural / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage; D002245:Carbon Dioxide / Q000378:metabolism; D005283:Fentanyl / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007278:Injections, Spinal; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D011292:Premedication; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects; D017409:Sufentanil / Q000008:administration & dosage; D013904:Thoracic Vertebrae; D013908:Thoracotomy
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002245:Carbon Dioxide; D009020:Morphine; D017409:Sufentanil; D010100:Oxygen; D005283:Fentanyl; D002045:Bupivacaine