Comparison of Epidural and Intravenous Methods for Post-Thoracotomy Analgesia; [Confronto Tra Analgesia Epidurale E Analgesia Endovenosa Per Interventi Di Toracotomia]



Ghafouri A¹ ; Movafegh A² ; Nasresfahani M¹ ; Gholamrezanezhad A¹ ; Madhkhan S³ Show Affiliations
Source: Acta Anaesthesiologica Italica / Anaesthesia and Intensive Care in Italy Published:2006

Abstract

Objective: Aim of the study was to evaluate the effectiveness of intermittent epidural analgesia using bupivacaine as compared to intermittent intravenous pethidine for postoperative analgesia. Methods: Fifty patients were randomly assigned into two groups: The first group received bupivacaine epidural analgesia and the second group received intermittent intravenous pethidine. The end points of the study were the total amount of additional pethidine received, postoperative pain and pulmonary function values. Results: In the second and third postoperative days the patients' pain scores were significantly higher in the intravenous group, but in the first 24 hour postoperative period there was no significant difference in the pain scores of both groups. Pulmonary function, as assessed by FVC, FEV1 and FEV1/FVC, was significantly better preserved in the epidural group. Intermittent epidural analgesia was associated with significantly lower daily requirement for total intravenous analgesia. Conclusions: Epidurally administered bupivacaine in our patients is a good alternative for post-thoracotomy pain management and postoperative pulmonary function improvement. Although epidural analgesia with bupivacaine should be used in conjunction with additional intravenous narcotics to achieve the best pain relief, it has an opioid sparing effect, which is beneficial.