title: The effect of pre-emptive intravenous Dexketoprofen + thoracal epidural analgesia on the chronic post-thoracotomy pain.
abstract: Post thoracotomy chronic pain is a severe problem that affects the majority of patients and decreases the quality of life. The purpose of this study is to evaluate the long-term effects of thoracal epidural levobupivacaine and intravenous dexketoprofen analgesia formed pre-emptively on the wound site pain after major thoracotomy operations. This randomised, prospective and double-blind study was performed with 60 patients undergoing thoracic surgery. Patients were divided into three groups; Control Group (Group C), Pre-emptive Epidural Group (Group PE) and Pre-emptive Dexketoprofen + Epidural Group (Group PED). Patients in the Group C did not receive epidural analgesics and i.v. dexketoprofen before and during the operation. 10-15 ml 0.125% levobupivacaine was given to cases in Group PE pre-emptively through epidural catheter before the anesthesia induction. The cases in Group PED were given 10-15 ml 0.125% epidural levobupivacaine and 50 mg dexketoprofen with i.v. infusion pre-emptively. The VAS score was found to be lower in Group PED during postoperative 24 and 48 hours and before the discharge (P<0.05). The VAS score was similar in all groups during the first and third months (P>0.05). A statistically significant decrease was determined in the VAS score in Group PED during the sixth month, compared to the other groups (P<0.05). When the scores of Patient Satisfaction Scale (PSS) of the cases were compared, they were found to be higher in Group PED as statistically significant during the discharge period (P<0.001). Scores of PSS were higher in Group PED as statistically significant during the postoperative month 6 (P = 0.008). Combined application of pre-emptive intravenous dexketoprofen and thoracal epidural analgesia reduce the chronic post-thoracotomy pain.
authors.affiliation: Department of Anaesthesiology, Erzurum Regional and Training Hospital Palandöken Erzurum 25070, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Comez
authors.affiliation: Department of Anaesthesiology and Reanimation, Ataturk University School of Medicine Palandöken Erzurum 25070, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Celik
authors.affiliation: Department of Anaesthesiology and Reanimation, Ataturk University School of Medicine Palandöken Erzurum 25070, Turkey.
authors.forename: Aysenur
authors.initials: A
authors.lastname: Dostbil
authors.affiliation: Department of Anaesthesiology and Reanimation, Ataturk University School of Medicine Palandöken Erzurum 25070, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aksoy
authors.affiliation: Department of Anaesthesiology and Reanimation, Ataturk University School of Medicine Palandöken Erzurum 25070, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Ahiskalioglu
authors.affiliation: Department of Anaesthesiology and Reanimation, Sakarya University School of Medicine Palandöken Erzurum 25070, Turkey.
authors.forename: Ali Fuat
authors.initials: AF
authors.lastname: Erdem
authors.affiliation: Department of Thorax surgery, Ataturk University School of Medicine Palandöken Erzurum 25070, Turkey.
authors.forename: Yener
authors.initials: Y
authors.lastname: Aydin
authors.affiliation: Department of Anaesthesiology and Reanimation, Ataturk University School of Medicine Palandöken Erzurum 25070, Turkey.
authors.forename: İlker
authors.initials: İ
authors.lastname: İnce
keywords: Pre-emptive epidural analgesia; dexketoprofen; post-thoracotomy pain