A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery
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Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
Bmc
Access Rights
info:eu-repo/semantics/openAccess
Abstract
Background: We aimed to compare patient-controlled thoracic or lumbar epidural analgesia methods after thoracotomy operations. Methods: One hundred and twenty patients were prospectively randomized to receive either thoracic epidural analgesia (TEA group) or lumbar epidural analgesia (LEA group). In both groups, epidural catheters were administered. Hemodynamic measurements, visual analog scale scores at rest (VAS-R) and after coughing (VAS-C), analgesic consumption, and side effects were compared at 0, 2, 4, 8, 16, and 24 hours postoperatively. Results: The VAS-R and VAS-C values were lower in the TEA group in comparison to the LEA group at 2, 4, 8, and 16 hours after surgery (for VAS-R, P = 0.001, P = 0.01, P = 0.008, and P = 0.029, respectively; and for VAS-C, P = 0.035, P = 0.023, P = 0.002, and P = 0.037, respectively). Total 24 hour analgesic consumption was different between groups (175 +/- 20 mL versus 185 +/- 31 mL; P = 0.034). The comparison of postoperative complications revealed that the incidence of hypotension (21/57, 36.8% versus 8/63, 12.7%; P = 0.002), bradycardia (9/57, 15.8% versus 2/63, 3.2%; P = 0.017), atelectasis (1/57, 1.8% versus 7/63, 11.1%; P = 0.04), and the need for intensive care unit (ICU) treatment (0/57, 0% versus 5/63, 7.9%; P = 0.03) were lower in the TEA group in comparison to the LEA group. Conclusions: TEA has beneficial hemostatic effects in comparison to LEA after thoracotomies along with more satisfactory pain relief profile.
Description
Keywords
Thoracic Epidural Analgesia, Lumbar Epidural Analgesia, Cardiac Enzymes, Visual Analog Scale, Postoperative Pain Management, Anesthesia, Sufentanil, Benefits, Risks
Journal or Series
World Journal Of Surgical Oncology
WoS Q Value
Q3
Scopus Q Value
Q1
Volume
12
