title: [Postoperative Analgesia for Video-assisted Thoracoscopic Surgery--Continuous Intravenous Infusion of Fentanyl Combined with Intercostal Nerve Block v.s. Continuous Epidural Analgesia].
abstract: BACKGROUND
  Epidural analgesia or paravertebral block is widely used in postoperative analgesia for video-assisted thoracic surgery (VATS). We investigated the efficacy of the continuous intravenous infuion of fentanyl combined with intercostal nerve block, in comparison with the continuous epidural analgesia.
  
  
  METHODS
  Forty-one patients received a bolus of 0.375% ropivacaine 6-10 ml through the epidural catheter placed at the T5-9 at the end of surgery. Then, continuous epidural infusion of 0.2% ropivacaine at a rate of 4 or 6 ml x hr(-1) was started (Group E). 44 patients received intercostal nerve block at three insertion points of thoracoscopy (using 0.75% ropivacaine 3-4 ml, respectively) at the end of surgery. Then, continuous intravenous infusion of fentanyl at a rate of 0.5 μg x kg(-1) x hr(-1) was started (Group F). The efficacy of post-operative analgesia was evaluated by additional analgesic requirements. RESULTS : There was no significant difference in the additional analgesic requirements between the two groups. However, the additional analgesics were required significantly earlier in Group E than Group F (P < 0.05).
  
  
  CONCLUSIONS
  Continuous intravenous infusion of fentanyl combined with intercostal nerve block is effective in the postoperative analgesia for VATS, as well as continuous epidural analgesia.
authors.forename: Kanako
authors.initials: K
authors.lastname: Hiro
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sugiyama
authors.forename: Masashi
authors.initials: M
authors.lastname: Kurata
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Oi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okuda
mesh_terms: D000368:Aged; D000577:Amides / Q000494:pharmacology; D015360:Analgesia, Epidural / Q000379:methods*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D000077212:Ropivacaine; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000077212:Ropivacaine; D005283:Fentanyl