title: [Lower thoracic epidural analgesia improves postoperative analgesia following vaginal total hysterectomy].
abstract: BACKGROUND
  In our hospital, lumbar epidural analgesia had been used for postoperative analgesia following vaginal total hysterectomy (VTH). But some patients experienced severe abdominal pain or numbness of the legs. Therefore we planned a randomized prospective study to compare lower thoracic epidural analgesia and lumbar epidural analgesia following VTH.
  
  
  METHODS
  Fifty patients were allocated to two groups: those who received lower thoracic epidural analgesia(T group)and the other who received lumbar epidural analgesia (L group). Both groupsreceived the same continuous epidural analgesia using fentanyl and ropivacaine after the operation.
  
  
  RESULTS
  The T group required significantly lower frequency of analgesic agents compared with that of the L group (2.5±1.9 times vs. 1.2±1.1 times, P< 0.05). Fewer patients in the T group had felt numbness in their legs compared to the L group (8% vs. 55%, P<0.05).
  
  
  CONCLUSIONS
  Lower thoracic epidural analgesia is more effective to provide postoperative analgesic effect following VTH compared with lumbar epidural analgesia.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kawanishi
authors.forename: Kaori
authors.initials: K
authors.lastname: Nakai
authors.forename: Akio
authors.initials: A
authors.lastname: Iseki
authors.forename: Kayo
authors.initials: K
authors.lastname: Nomura
authors.forename: Michihisa
authors.initials: M
authors.lastname: Kato
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Go
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000577:Amides; D015360:Analgesia, Epidural / Q000379:methods*; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D005260:Female; D005283:Fentanyl; D006801:Humans; D007045:Hysterectomy, Vaginal; D008159:Lumbar Vertebrae; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine; D013904:Thoracic Vertebrae; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000077212:Ropivacaine; D005283:Fentanyl