Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: Randomized clinical trial Alívio da dor pós-toracotomia com analgesia subpleural ou analgesia epidural torácica: Ensaio clínico randomizado
Sao Paulo Medical Journal, cilt.134, sa.4, ss.280-284, 2016 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 134 Sayı: 4
- Basım Tarihi: 2016
- Doi Numarası: 10.1590/1516-3180.2015.00462405
- Dergi Adı: Sao Paulo Medical Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.280-284
- Anahtar Kelimeler: Analgesia, Epidural, Analgesia, Patient-controlled, Pain, Postoperative, Pleura, Thoracotomy
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
© 2016, Associacao Paulista de Medicina. All rights reserved.CONTEXT AND OBJECTIVE: Post-thoracotomy pain is a severe and intense pain caused by trauma to ribs, muscles and peripheral nerves. The current study aimed to compare subpleural analgesia (SPA) with thoracic epidural analgesia (TEA) in patients undergoing thoracotomy. DESIGN AND SETTING: Randomized study at Ankara Numune Education and Research Hospital, in Turkey. METHODS: Thirty patients presenting American Society of Anesthesiologists physical status I-III were scheduled for elective diagnostic thoracotomy. The patients were randomized to receive either patientcontrolled SPA or patient-controlled TEA for post-thoracotomy pain control over a 24-hour period. The two groups received a mixture of 3 μg/ml fentanyl along with 0.05% bupivacaine solution through a patientcontrolled analgesia pump. Rescue analgesia was administered intravenously, consisting of 100 mg tramadol in both groups. A visual analogue scale was used to assess pain at rest and during coughing over the course of 24 hours postoperatively. RESULTS: In the SPA group, all the patients required rescue analgesia, and five patients (33%) required rescue analgesia in the TEA group (P < 0.05). Patients who received subpleural analgesia exhibited higher visual analogue scores at rest and on coughing than patients who received thoracic epidural analgesia. None of the patients had any side-effects postoperatively, such as hypotension or respiratory depression. CONCLUSION: Thoracic epidural analgesia is superior to subpleural analgesia for relieving postthoracotomy pain. We suggest that studies on effective drug dosages for providing subpleural analgesia are necessary.