Post-thoracotomy analgesia--comparison epidural fentanyl to intravenous pethidine.

Abstract

BACKGROUND AND METHODS:

To evaluate the efficacy of postthoracotomy analgesia with intermittent epidural fentanyl. 50 patients were allocated randomly into 2 groups. The first group received intermittent epidural fentanyl and the second group received intermittent intravenous analgesia using pethidine. The variables studied were: pain score; total amount of additional intravenous opioid analgesia, and ventilatory function parameters [forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and FEV1/FVC ratio]:

RESULTS:

In the first postoperative day, pain scores were higher in the epidural group (P = 0.034), but there was no significant difference between mean pain scores in the second and third days (P = 0.61, P = 0.15, respectively). On all three days, significantly more additional analgesics were required in the epidural group. A difference was found between both groups in the post- to pre-operative FEV1, FVC and FEV1/FVC ratios, with the better preservation of the ventilatory function in the epidural group (P = 0.001, 0.013, <0.0001, respectively).

CONCLUSION:

The analgesic effect of intermittent epidural fentanyl is not adequate and postoperative pain relief has not any significant advantage over the more easily-applied intravenous analgesia. However, better preservation of ventilatory function makes epidural fentanyl a useful adjunct analgesia in reduction of post-thoracotomy pulmonary complications.

• Authors: Ali Movafegh, Ali Ghafouri, Mehran Nasr-Esfahani, Ali Gholamrezanezhad, Sepide Madhkhan
• Journal: Middle East journal of anaesthesiology (Middle East J Anaesthesiol) Vol. 19 Issue 1 Pg. 111-22 (Feb 2007) ISSN: 0544-0440 [Print] Lebanon
• PMID: 17511187 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Opioid
• Meperidine
• Fentanyl

Topics

• Adolescent
• Adult
• Analgesics, Opioid (administration & dosage, therapeutic use)
• Anesthesia, Epidural
• Female
• Fentanyl (therapeutic use)
• Forced Expiratory Volume (drug effects)
• Humans
• Injections, Intravenous
• Male
• Meperidine (therapeutic use)
• Middle Aged
• Pain Measurement (drug effects)
• Pain, Postoperative (drug therapy)
• Prospective Studies
• Respiratory Function Tests
• Thoracotomy
• Vital Capacity (drug effects)