PMID: 15232813Jul 3, 2004Paper

Analgesia after thoracotomy: epidural fentanyl/bupivacaine compared with intercostal nerve block plus intravenous morphine

Journal of Cardiothoracic and Vascular Anesthesia
Mario ConchaMario Guerrero

Abstract

Intercostal nerve blockade plus intravenous (IV) patient-controlled analgesia (PCA) could be an easier and safer alternative to epidural analgesia for postthoracotomy pain, but information about the efficacy of this technique is scarce. The objective of this randomized study was to compare the quality of analgesia and lung function in 2 groups of patients undergoing pulmonary surgery through a posterolateral thoracotomy. Two groups were studied: G1 (n = 16) patients received a 5-segment intercostal block plus IV PCA morphine, and G2 (n = 15) patients received a bupivacaine and fentanyl PCA infusion through a thoracic epidural catheter. Resting and dynamic visual analog pain scale (VAS) measurements, forced vital capacity, and forced expiratory volume in 1 second were measured basally, on arrival in the recovery room, then hourly up to 4 hours and then 12, 24 and 48 hours later. Results were analyzed with a 2-way analysis of variance, chi-square, or Fisher exact test. A p value < or =0.05 was considered significant. Resting and dynamic VAS scores were slightly lower in G2 patients, although only resting scores were significant. After the first hour, mean scores were below 4 in both groups. No significant difference was observed ...Continue Reading

References

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Citations

May 16, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Rodolfo GebhardtThomas W Feeley
Oct 7, 2008·Journal of Cardiothoracic and Vascular Anesthesia·Scott S Reuben, Lakshmi Yalavarthy
Dec 7, 2007·Anesthesiology Clinics·John D Markman, Annie Philip
Mar 6, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·P MicheletJ-P Auffray
Feb 27, 2007·The Medical Clinics of North America·John D Markman, Annie Philip
Sep 29, 2006·Thoracic Surgery Clinics·Richard P Koehler, Robert J Keenan
Oct 7, 2006·Journal of Cardiothoracic and Vascular Anesthesia·David S MarshakJoann Thomson
Feb 19, 2015·British Journal of Anaesthesia·J KesslerM W Hollmann
Oct 4, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Mediha TurktanGeylan Isik
Nov 19, 2015·São Paulo Medical Journal = Revista Paulista De Medicina·Aysu Hayriye TezcanMustafa Baydar
Jul 26, 2005·Peptides·Richard J Bodnar, Gad E Klein
Jun 4, 2020·Indian Journal of Anaesthesia·Priya RanganathanC S Pramesh
Mar 24, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·L Beaudroit, J Ripart

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