PERIOPERATIVE THORACIC EPIDURAL ANALGESIA FOR THORACOTOMY

In a prospective study, experiences with peri-operative thoracic epidu ral analgesia (TEA) for thoracic surgery were documented. Two hundred and seven patients scheduled for elective thoracotomy were investigate d. All patients received thoracic epidural catheters 2 h pre-operative ly. The catheters were inserted between T4-5 and T8-9 intervertebral s paces. Epidural medication with bupivacaine and fentanyl was started p reoperatively, maintained throughout surgery and was continued post-op eratively via patient controlled analgesia (PCA) devices. Patients wer e anaesthetized with propofol and tracheal intubation was performed fo llowing neuromuscular blockade with vecuronium. Ninety-five percent of the patients were extubated immediately after surgery. 70.5% of all t he patients had excellent post-operative analgesia (VAS pain scoring 0 -2) on the day of surgery, 78% the day after surgery and 91% on the se cond day after surgery. Additionally early post-operative mobilization could be started in 63% of all patients. No neurological sequelae cau sed by thoracic epidural catheterization was seen in the early post-op erative period.