[Prolonged epidural analgesia following thoracotomy. Clinical study and serum levels over five days]

Ann Chir. 1991;45(2):167-76.
[Article in French]

Abstract

Prolonged continuous epidural analgesia allows perithecal infusion with fentanyl and bupivacaine for 5 postoperative days after thoracic surgery. This study included 27 thoracotomized patients randomised into two groups: group X consisted of 15 subjects, group Y consisted of 12 subjects. Each patient received 33 micrograms/hr or fentanyl for 48 hours, associated with 0.25% bupivacaine in group X, and 0.125% bupivacaine in group Y. Over the three last days, the infusion rate of both drugs was decreased in the two groups. No significant clinical difference appeared between X and Y. No clinical respiratory depression occurred. In group Y, mean plasma bupivacaine concentrations remained significantly lower (p less than 0.05). Mean fentanyl levels did not increase beyond 0.8 ng/ml. The use of 0.125% bupivacaine improved the margin of safety but did not impair clinical analgesia in the study. This method provides good analgesia for thoracotomized patients.

Publication types

  • Clinical Trial
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesia, Epidural / methods*
  • Bupivacaine / adverse effects
  • Bupivacaine / blood*
  • Bupivacaine / therapeutic use
  • Female
  • Fentanyl / adverse effects
  • Fentanyl / blood*
  • Fentanyl / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / drug therapy*
  • Postoperative Care
  • Randomized Controlled Trials as Topic
  • Respiratory Function Tests
  • Thoracic Diseases / surgery
  • Thoracotomy

Substances

  • Fentanyl
  • Bupivacaine