The comparison of patient controlled epidural analgesia with bupivacaine versus systemic patient controlled analgesia with meperidine in the management of post-thoracotomy pain Torakotomi Sonrasi Aǧri Tedavisinde Hasta Kontrollü Epidural Bupivakain Analjezisiyle Hasta Kontrollü Sistemik Meperidin Analjezisinin Karşilaştirilmasi

Meydan B., Helvaci A., Bulut M., CAN G.

Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.9, sa.2, ss.66-71, 2003 (Scopus) identifier

Özet

In our study, we aimed to compare the efficacy of thoracic epidural PCA bupivacaine with systemic meperidine in the management of postoperative pain after thoracotomy. 40 patients scheduled for elective thoracotomy were included in this study and were randomly divided into 2 groups (n=20 in each Group) to receive either thoracic epidural bupivacaine (TEB) or systemic meperidine (SM). In the postoperative period, PCA was started for thoracotomy analgesia. All of the cases were observed with 1 hour interval for the first 24 hours. Statistical analyses were performed using one-way analysis of variance (ANOVA) and Fisher's exact test. While mean arterial pressure was significantly lower in TEB group at 1-14 hours postoperatively (p<0.001), the difference was not statistically significant in SM group. When compared to initial values, VAS was lower in all measurements after 1st postop hour (p<0.0001) in TEB group, where as statistically lower VAS values were obtained after postop 6th hour (p<0.001) in the SM group. Incidence of nausea was higher in TEB group (p<0.05), whereas ipsilateral shoulder pain was more frequent in SM group (p<0.05). We conclude that thoracic epidural analgesia may be preferred to systemic opioids, but close attention is needed to prevent serious hypotension in the first post-operative hours.