Preemptive epidural analgesia for thoracic surgery

The purpose of this study was to determine if preemptive epidural analgesia performed before thoracotomy incision and during the operation reduces postoperative pain. Patients in the treatment group received 8 mL of 0.25% bupivacaine and 2 mL of fentanyl (50 microg/mL) via the epidural route prior to skin incision, followed by an infusion of bupivacaine 0.1% and fentanyl 10 microg/mL at 6 mL/hr. The control group received saline in the epidural. All patients in both groups were dosed with 8 mL of 0.25% bupivacaine and 2 mL of fentanyl 50 microg/mL via the epidural route at the time of the chest closure. The patients in the treatment group required less isoflurane intraoperatively and had lower maximum pain scores in the first 6 hours postoperatively. No significant differences were noted after the first 6 hours.