title: A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery.
abstract: BACKGROUND
  We aimed to compare patient-controlled thoracic or lumbar epidural analgesia methods after thoracotomy operations.
  
  
  METHODS
  One hundred and twenty patients were prospectively randomized to receive either thoracic epidural analgesia (TEA group) or lumbar epidural analgesia (LEA group). In both groups, epidural catheters were administered. Hemodynamic measurements, visual analog scale scores at rest (VAS-R) and after coughing (VAS-C), analgesic consumption, and side effects were compared at 0, 2, 4, 8, 16, and 24 hours postoperatively.
  
  
  RESULTS
  The VAS-R and VAS-C values were lower in the TEA group in comparison to the LEA group at 2, 4, 8, and 16 hours after surgery (for VAS-R, P = 0.001, P = 0.01, P = 0.008, and P = 0.029, respectively; and for VAS-C, P = 0.035, P = 0.023, P = 0.002, and P = 0.037, respectively). Total 24-hour analgesic consumption was different between groups (175 +/- 20 mL versus 185 +/- 31 mL; P = 0.034). The comparison of postoperative complications revealed that the incidence of hypotension (21/57, 36.8% versus 8/63, 12.7%; P = 0.002), bradycardia (9/57, 15.8% versus 2/63, 3.2%; P = 0.017), atelectasis (1/57, 1.8% versus 7/63, 11.1%; P = 0.04), and the need for intensive care unit (ICU) treatment (0/57, 0% versus 5/63, 7.9%; P = 0.03) were lower in the TEA group in comparison to the LEA group.
  
  
  CONCLUSIONS
  TEA has beneficial hemostatic effects in comparison to LEA after thoracotomies along with more satisfactory pain relief profile.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine Houses, Trakya University, D- Bloc, No: 8, Edirne, Turkey. gonulsagiroglu45@gmail.com.
authors.forename: Gonul
authors.initials: G
authors.lastname: Sagiroglu
authors.forename: Burhan
authors.initials: B
authors.lastname: Meydan
authors.forename: Elif
authors.initials: E
authors.lastname: Copuroglu
authors.forename: Ayse
authors.initials: A
authors.lastname: Baysal
authors.forename: Yener
authors.initials: Y
authors.lastname: Yoruk
authors.forename: Yekta
authors.initials: Y
authors.lastname: Altemur Karamustafaoglu
authors.forename: Serhat
authors.initials: S
authors.lastname: Huseyin
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage*; D018287:Carcinoma, Large Cell / Q000150:complications / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology / Q000601:surgery; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D013908:Thoracotomy / Q000009:adverse effects*
chemical_list: D000700:Analgesics