Thoracic epidural anesthesia and analgesia during the perioperative period of thoracic surgery: levobupivacaine versus bupivacaine.
OBJECTIVE
To compare the effects of thoracic epidural anesthesia with levobupivacaine or bupivacaine on block features, intraoperative hemodynamics, and postoperative analgesia for thoracic surgery.


METHODS
A prospective, randomized, and double-blind study.


METHODS
A university hospital.


METHODS
Fifty patients undergoing thoracic surgery.


METHODS
Patients received thoracic epidural catheterization either with levobupivacaine or bupivacaine. A bolus of 0.1 mL/kg of 0.25% levobupivacaine or 0.25% bupivacaine was administered, and infusion of the same drug with 0.25% concentration was started at 0.1 mL/kg/h. General anesthesia was induced after assessing the sensory block and maintained with 0.3% to 0.8% isoflurane and 50% O(2) in air. Epidural patient-controlled analgesia with the same agent was started at the end of the operation for 48 hours postoperatively.


RESULTS
Sensory block features such as onset time and spread were assessed for the next 20 minutes after the bolus dose. Heart rate and systolic, diastolic, and mean arterial blood pressures were recorded intraoperatively and postoperatively. Pain at rest and activity was evaluated by the visual analog scale (VAS) for 48 hours after the operation. All patients were comparable with respect to the demographic data. Onset time of the block and the number of blocked dermatomes and hemodynamic parameters were similar in both groups. All VAS assessments were comparable between groups except VAS at the 36th hour postoperative, which was higher in the levobupivacaine group (p = 0.039).


CONCLUSIONS
Thoracic epidural anesthesia with either levobupivacaine or bupivacaine provided comparable sensory block features, intraoperative hemodynamics, and postoperative analgesia for thoracic surgery.
Cok
Oya Yalcin
OY
Department of Anaesthesiology and Reanimation, Başkent University, Ankara, Turkey. oyacok@yahoo.com
Eker
H Evren
HE
Turkoz
Ayda
A
Findikcioglu
Alper
A
Akin
Sule
S
Aribogan
Anis
A
Arslan
Gulnaz
G
D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D000767:Anesthesia, Epidural / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage* / Q000031:analogs & derivatives; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D059035:Perioperative Period / Q000379:methods; D011446:Prospective Studies; D019616:Thoracic Surgical Procedures / Q000009:adverse effects
D000077554:Levobupivacaine; D002045:Bupivacaine