Comparison of adequacy of Analgesia between thoracic epidural infusion of fentanyl with bupivacaine to fentanyl alone for post thoracotomy pain relief

Dr. Anita Behera; Dr. Rakhi KR

Volume : VII, Issue : V, May - 2018

Comparison of adequacy of Analgesia between thoracic epidural infusion of fentanyl with bupivacaine to fentanyl alone for post thoracotomy pain relief

Dr. Anita Behera, Dr. Rakhi Kr

Abstract :

Background: Optimum pain relief following thoracotomy is essential for patient comfort and to reduce theincidence of postoperative pulmonary complications.

Methods:

A randomized clinical trial was conducted Amrita institute of Medical Science, Kochi. 60 patients scheduled for thoracotomy procedure in between 2009 to 2012. Thepatients were randomly divided into two groups. Group A received 0.125% bupivicaine with fentanyl 10 �g.ml–¹,

Group B received only fentanyl 10�g.ml–¹ in acalculated dose as a continuous thoracic epidural infusion.

Adequacy of analgesia was assessed at rest and duringmovement over 24 hours. Analgesic efficacy was assessed

using a visual analogue score and an observer verbalranking scale.

Results:

It was observed that Group A patients had lower pain score than Group B.There was no significant differences in the incidence of adverse effects among the two groups. However the use of intraoperative vasopressors was significantly higher (p<0.05) in Group A as comparedto group B. The incidence of Nausea, Vomiting, pruritus, respiratory depression & sedation were more frequrent in Group B. No neurological complications were encountered in any of the study groups.

Conclusion:we conclude that the benefit from the addition of 0.125% bupivacaine to fentanyl (l0mcg.ml–¹) in thoracic epidural analgesia is confined to the early postoperative period after thoracotomy.