title: [Patient controlled epidural analgesia: interest in thoracic surgery].
abstract: OBJECTIVE
  To compare efficacy of pain control, the consumption of local anaesthetics and opioids as well as the side effects between continuous epidural analgesia, patient controlled analgesia and patient controlled epidural analgesia in thoracic surgery.
  
  
  METHODS
  Prospective randomised study included 66 patients who had thoracotomy. Patients were divided into 3 groups, to receive different pain control methods. Group 1 (n=22) received patient control analgesia Group 2 (n=22) received continuous epidural analgesia (Bupivacaine 0,125% + 5 microg/ml of Fentanyl) between 6 and 10 ml/h in order to obtain a T2 level Group 3 (n=22) received patient controlled epidural analgesia (Bupivacaine 0,08% + 3 microg/ml of Fentanyl) 6 ml/h and bolus of 5 ml.
  
  
  RESULTS
  There was no difference between the three groups in age, delay of surgical operation and per operative morphine consumption. VAS was less at rest and after cough in patient group with patient controlled epidural analgesia. The difference was less significant in local anaesthetics and opioids consumption in patient with controlled epidural analgesia.
  
  
  CONCLUSIONS
  The benefit of patient controlled epidural analgesia in thoracic surgery is proven by the following analgesic efficiency which allows good respiratory rehabilitation, decreasing the risk of drug toxicity by decreases consumption, weak hemodynamic effects and absence of motor block.
authors.affiliation: Service d'Anesthésie-Réanimation, CHU Mongi Slim, La Marsa,Tunisie.
authors.forename: Walid
authors.initials: W
authors.lastname: Kammoun
authors.forename: Tahar
authors.initials: T
authors.lastname: Mestiri
authors.forename: Walid
authors.initials: W
authors.lastname: Miraoui
authors.forename: Nabil
authors.initials: N
authors.lastname: Frikha
authors.forename: Mhamed Sami
authors.initials: MS
authors.lastname: Mebazaa
authors.forename: Tarak
authors.initials: T
authors.lastname: Kilani
authors.forename: Mohamed Salah
authors.initials: MS
authors.lastname: Ben Ammar
mesh_terms: D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D013908:Thoracotomy
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local