Sv. Mahon et al., Thoracic epidural infusions for post-thoracotomy pain: a comparison of fentanyl-bupivacaine mixtures vs. fentanyl alone, ANAESTHESIA, 54(7), 1999, pp. 641-646
Citations number
21
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
A randomised double-blind clinical trial was conducted on 106 patients sche
duled for pulmonary resection. Patients received an epidural infusion conta
ining 0.1%, 0.2% bupivacaine or saline in combination with fentanyl 10 mu g
.ml(-1). Adequacy of analgesia was assessed at rest and during movement ove
r 24 h. Analgesic efficacy was assessed using visual analogue scores and an
observer/verbal ranking scale. Pain scores were higher in the fentanyl-onl
y group at the 2 h assessment (p < 0.05). Otherwise, there were no between-
group differences in pain scores or in the total amounts of epidural soluti
on used. All patients received continuous haemodynamic monitoring. There we
re no between-group differences in the number of episodes of hypotension or
in the number of interventions for hypotension. However, the use of intra-
operative vasopressor and the incidence of temporary neurological complicat
ions was higher in the 0.2% bupivacaine group (p < 0.05). We conclude that,
in the early postoperative period, the addition of bupivacaine 0.1% improv
es fentanyl epidural analgesia in patients undergoing lung resection and is
not associated with the disadvantages seen with the addition of bupivacain
e 0.2%.