Interpleural versus epidural analgesia with ropivacaine for postthoracotomy pain and respiratory function.
OBJECTIVE
To evaluate the impact of interpleural analgesia (IP) on postthoracotomy pain and respiratory function as an alternative to thoracic epidural analgesia (TEA).


METHODS
Prospective, randomized study.


METHODS
Tertiary-care military hospital.


METHODS
Sixty young patients scheduled for elective thoracic surgery (correction of aorta coarctation and patent ductus arteriosus).


METHODS
Patients were randomized into two groups to receive either IP or TEA for postthoracotomy pain management.


METHODS
Patients in the IP group (n = 30) had a catheter inserted between the parietal and visceral pleura by a surgeon, and 0.2% ropivacaine was given through this catheter. In the TEA group, ropivacaine was administered through a thoracic epidural catheter. The impact of both methods on pain control, respiratory function, and pulmonary complications was analyzed and compared.


RESULTS
The frequency of atelectasis and pleural effusion was also significantly high in the IP group (P < 0.01). Respiratory function and postoperative pain scores were better in the TEA group (P < 0.01). Arterial blood gas analysis on the fifth postoperative day was significantly better in the TEA group.


CONCLUSIONS
Thoracic epidural analgesia has more beneficial effects on respiratory function and postoperative pain after thoracotomy than does IP.
Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy, Ankara, Turkey.
Vedat
V
Yildirim
Hakki Tankut
HT
Akay
Hakan
H
Bingol
Cengiz
C
Bolcal
Kursad
K
Oz
Erkan
E
Kaya
Ufuk
U
Demirkilic
Harun
H
Tatar
D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D000698:Analgesia / Q000009:adverse effects; D015360:Analgesia, Epidural / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D001017:Aortic Coarctation / Q000601:surgery; D001784:Blood Gas Analysis; D004374:Ductus Arteriosus, Patent / Q000601:surgery; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D007267:Injections; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010994:Pleura; D010996:Pleural Effusion / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000453:epidemiology / Q000209:etiology; D012129:Respiratory Function Tests; D000077212:Ropivacaine; D013908:Thoracotomy
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine