Continuous epidural or intercostal analgesia following thoracotomy:: a prospective randomized double-blind clinical trial

被引:45
|
作者
Debreceni, G
Molnár, Z
Szélig, L
Molnár, TF
机构
[1] Univ Pecs, Dept Anaesthesiol & Intens Therapy, H-7643 Pecs, Hungary
[2] Univ Pecs, Dept Thorac Surg, H-7643 Pecs, Hungary
关键词
epidural analgesia; intercostal analgesia; post-thoracotomy; pain; pulmonary function test;
D O I
10.1034/j.1399-6576.2003.00208.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Pain following thoracotomy is frequently associated with clinically important abnormalities of pulmonary function. The aim of the current study was to compare the efficacy of continuous thoracic epidural analgesia (EDA) to continuous intercostal (IC) block for postoperative pain and pulmonary function in a prospective, randomized, double-blinded clinical trial. Methods: Fifty patients undergoing lung lobectomy for malignancies were randomized into two groups (25/group). Respiratory function ( forced vital capacity, forced expiratory volume per 1 s/forced vital capacity, maximum midexpiratory flow rate, peak expiratory flow rate) were evaluated preoperatively, within 4 h after the operation and on the first postoperative day. Visual analog scale ( VAS: 0 - 10) scores were evaluated four-hourly for 20 h. Results: The VAS scores were significantly lower in the EDA versus IC group at the 4th, 8th, and 12th h of observation ( mean +/- SD) 5.5 +/- 2.9 vs. 7.3 +/- 2.2 P = 0.04; 4.1 +/- 2.1 vs. 5.1 +/- 2.9 P = 0.02; 3.6 +/- 1.9 vs. 5.2 +/- 2.4 P = 0.01, respectively. Respiratory function parameters deteriorated significantly in both groups ( P< 0.001) with no significant difference between the groups. Only one major adverse effect was detected: one patient suffered from rib osteomyelitis after intercostal cannulation and healed following surgical repair. Conclusions: The results of the present study show that following thoracotomy in the early postoperative period continuous EDA is a better pain relieving method than continuous IC block, as indicated by the VAS scores.
引用
收藏
页码:1091 / 1095
页数:5
相关论文
共 50 条
  • [1] Continuous thoracic epidural analgesia following thoracotomy: A randomized, double blind, prospective study comparing epidural bupivacaine and morphine versus morphine alone
    McGrath, TJ
    Frank, ED
    Corba, R
    Schmidt, M
    Torjman, MC
    Viscusi, ER
    [J]. ANESTHESIA AND ANALGESIA, 1998, 86 (2S):
  • [2] Postoperative epidural analgesia by methylprednisolone (MP) after posterolateral thoracotomy: A prospective, randomized, double-blind study
    Blanloeil, Y
    Leroux, C
    Bizouarn, P
    Rigal, JC
    Leteurnier, Y
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 1999, 82 : 192 - 192
  • [3] Analgesia in patients undergoing thoracotomy: Epidural versus paravertebral technique. A randomized, double-blind, prospective study
    Raveglia, Federico
    Rizzi, Alessandro
    Leporati, Andrea
    Di Mauro, Piero
    Cioffi, Ugo
    Baisi, Alessandro
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2014, 147 (01): : 469 - 474
  • [4] A RANDOMIZED DOUBLE-BLIND COMPARISON OF EPIDURAL VERSUS INTRAVENOUS FENTANYL INFUSION FOR ANALGESIA AFTER THORACOTOMY
    SALOMAKI, TE
    LAITINEN, JO
    NUUTINEN, LS
    [J]. ANESTHESIOLOGY, 1991, 75 (05) : 790 - 795
  • [5] Can analgesia with intercostal catheter be an alternative to epidural analgesia for thoracotomy? A prospective study
    Guclu, Cigdem Yildirim
    Meco, Basak Ceyda
    Bermede, Ahmet Onat
    Erkoc, Suheyla Karadag
    Yenigun, Bulent Mustafa
    Safak, Bengi
    Guven, Aysegul
    [J]. ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, 2023, 14 (12): : 1077 - 1080
  • [6] Efficacy and Safety of Epidural Chloroprocaine for Breakthrough Pain During Labor Analgesia: A Prospective, Double-Blind, Randomized Trial
    Ji, Tianzhen
    Jiang, Can
    Liu, Hongxia
    Cai, Zhehao
    Liu, Rongrong
    Xie, Lei
    Xu, Cheng
    [J]. PAIN AND THERAPY, 2024, 13 (02) : 227 - 239
  • [7] Efficacy and Safety of Epidural Chloroprocaine for Breakthrough Pain During Labor Analgesia: A Prospective, Double-Blind, Randomized Trial
    Tianzhen Ji
    Can Jiang
    Hongxia Liu
    Zhehao Cai
    Rongrong Liu
    Lei Xie
    Cheng Xu
    [J]. Pain and Therapy, 2024, 13 : 227 - 239
  • [8] CONTINUOUS THORACIC EPIDURAL ANALGESIA FOR POSTOPERATIVE PAIN RELIEF FOLLOWING THORACOTOMY - A RANDOMIZED PROSPECTIVE-STUDY
    LOGAS, WG
    ELBAZ, N
    ELGANZOURI, A
    CULLEN, M
    STAREN, E
    FABER, LP
    IVANKOVICH, AD
    [J]. ANESTHESIOLOGY, 1987, 67 (05) : 787 - 791
  • [9] PAIN FOLLOWING THORACOTOMY - A RANDOMIZED, DOUBLE-BLIND COMPARISON OF LUMBAR VERSUS THORACIC EPIDURAL FENTANYL
    COE, A
    SARGINSON, R
    SMITH, MW
    DONNELLY, RJ
    RUSSELL, GN
    [J]. ANAESTHESIA, 1991, 46 (11) : 918 - 921
  • [10] Preemptive analgesia for hemorrhoidectomy: study protocol for a prospective, randomized, double-blind trial
    Ekaterina Kazachenko
    Tatiana Garmanova
    Alexander Derinov
    Daniil Markaryan
    Hanjoo Lee
    Sabrina Magbulova
    Petr Tsarkov
    [J]. Trials, 23