• Eur J Cardiothorac Surg · Sep 2003

    Randomized Controlled Trial Comparative Study Clinical Trial

    Early postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural analgesia: a randomised study.

    • Arif Yegin, Abdullah Erdogan, Nurten Kayacan, and Bilge Karsli.
    • Department of Anaesthesiology, Akdeniz University Medical Faculty, Antalya, Turkey. ayegin@ixir.com
    • Eur J Cardiothorac Surg. 2003 Sep 1;24(3):420-4.

    ObjectivesEffective analgesia and blockade of the perioperative stress response may improve outcome and epidural analgesia plays a role in the reduction of pulmonary complications following thoracic surgery. In this study, we assessed preoperative and postoperative thoracic epidural analgesia (Preop-TEA and Postop-TEA) techniques on post-thoracotomy pain in 61 patients undergoing posterolateral thoracotomy.MethodsA thoracic epidural catheter was inserted into all the patients before surgery. In Group I, 8 mL of 0.25% bupivacaine plus fentanyl 50 microg in 2 mL was administered preoperatively. In Group II, no medication was administered via the epidural catheter preoperatively and intraoperatively. Postoperative analgesia was maintained with patient-controlled epidural analgesia with bupivacaine and fentanyl solution in both groups. Pain was evaluated at 2, 4, 8, 12, 24 and 48 h at rest and coughing.ResultsPreop-TEA Group was associated with decreased pain compared with the Postop-TEA Group.ConclusionsIn conclusion, preoperative epidural analgesia is an appropriate method for post-thoracotomy pain and is more effective in preventing acute postoperative pain.

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