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Continuous epidural hydromorphone for postthoracotomy pain relief.
J B Brodsky1, S R Chaplan, W G Brose
1Department of Anesthesia, Stanford University School of Medicine, California.
The Annals of Thoracic Surgery
|December 1, 1990
Summary
Continuous lumbar epidural hydromorphone infusion effectively managed pain after thoracic surgery. This method provided safe, predictable analgesia with a low incidence of side effects in patients.
Area of Science:
- Anesthesiology
- Pain Management
- Thoracic Surgery
Background:
- Post-thoracotomy pain can be severe and difficult to manage.
- Epidural analgesia is a common method for managing postoperative pain.
- Hydromorphone is a potent opioid used for pain relief.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous lumbar epidural hydromorphone infusion for analgesia after thoracic operations.
Main Methods:
- Forty-four patients undergoing thoracic surgery received continuous lumbar epidural hydromorphone (0.05%).
- Postoperative pain was assessed using visual analog pain scores at rest.
- Incidence of side effects such as hypoventilation, pruritus, and nausea was recorded.
Main Results:
- Over 90% of patients reported no or mild pain (VAS 0-3) on postoperative days 1 and 2.
- The incidence of adverse effects was lower compared to other epidurally administered opioids.
- Continuous infusion demonstrated predictable and effective pain control.
Conclusions:
- Continuous lumbar epidural hydromorphone infusion is a safe and effective method for managing postoperative pain following thoracotomy.
- This approach offers predictable analgesia with a favorable side effect profile.
- Lumbar epidural hydromorphone provides a viable option for enhanced recovery after thoracic surgery.