[Efficacy of various epidural analgesia regimens after lung surgery].
A prospective study included 90 adult patients undergoing thoracic surgery. After placing an epidural catheter at the Th4-Th5 level, all the patients were randomized in 3 groups. Twenty-nine patients received controlled epidural analgesia (PCEA) with fentanyl, 2 microg/ml, in 0.2% bupivacaine solution (Group 1). In other groups, these analgesics were given either as bolus infections (Group 2; n = 30) or as a continuous epidural infusion of fentanyl, 2 microg/ml, in 0.2% bupivacane solution (Group 3; n = 27). Pain scores and the incidence of adverse effects were assessed within the first 24 hours after surgery. The data were compared using the Student's t-test and x2 test with Bonferroni correction; p < 0.017 was regarded as statistically significant. The VAS scores in coating were significantly lower in Group 1 than in Groups 2 and 3. The need for epidural opioids for adequate analgesia within the first 24 hours after surgery was significantly less in Group 1 than in Groups 2 and 3. There were no excessive sedation episodes in all the groups. In Group 2, the incidence of nausea was 20%. These adverse reactions were not found during PCEA and continuous infusion (p < 0.017). Opioid-induced pruritus was mostly (23%) observed in Group 2. Thoracic PCEA with fentanyl-bupivacaine solution provided adequate postoperative analgesia after thoracotomy and reduced the need for opioids. In addition, PCEA reduced the incidence of adverse reactions of opioids.
Uvarov
D N
DN
Orlov
M M
MM
Fedoseev
V F
VF
Berezin
A V
AV
Nedashkovskiĭ
E V
EV
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008168:Lung / Q000601:surgery*; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D013903:Thoracic Surgery
D000700:Analgesics