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Early postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural
Arif Yegin1, Abdullah Erdogan, Nurten Kayacan
1Department of Anaesthesiology, Akdeniz University Medical Faculty, Antalya, Turkey. ayegin@ixir.com
Objectives:
Effective 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.
Methods:
A 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.
Results:
Preop-TEA Group was associated with decreased pain compared with the Postop-TEA Group.
Conclusions:
In conclusion, preoperative epidural analgesia is an appropriate method for post-thoracotomy pain and is more effective in preventing acute postoperative pain.