Epidural infusion of levobupivacaine and sufentanil following thoracotomy.
A prospective, randomised, double-blind study was conducted to compare the efficacy of two doses of levobupivacaine combined with sufentanil for continuous epidural infusion following thoractomy. A total of 72 patients undergoing lobectomy or pneumonectomy were enrolled. An epidural catheter was inserted between the levels of T4 and T6 before induction of anaesthesia and a loading dose of levobupivacaine and sufentanil was administered. At the end of surgery an epidural infusion was commenced at 5 mlxh(-1) and continued for 48 h. Patients were randomly allocated to receive either levobupivacaine 0.125% (group A) or 0.0625% (group B) and all patients also received sufentanil (1 microgxml(-1)). Visual analogue pain scores after coughing (VASi) were always higher in group B (p < 0.05); VAS pain scores at rest were higher for the first 4 h and at 16 and 28 h in group B (p < 0.05). Total morphine consumption and requests number was lower in group A (p < 0.05). Better pain relief was achieved using epidural 0.125% levobupivacaine.
De Cosmo
G
G
Department of Anaesthesiology and Intensive Care, Policlinico Universitario A. Gemelli, Rome, Italy. gdecosmo@rm.unicatt.it
Congedo
E
E
Mascia
A
A
Adducci
E
E
Lai
C
C
Aceto
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D017409:Sufentanil / Q000008:administration & dosage / Q000009:adverse effects; D013908:Thoracotomy
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D000077554:Levobupivacaine; D017409:Sufentanil; D002045:Bupivacaine