THORACIC EPIDURAL ANALGESIA

OPTIMAL TECHNIQUE FOR POSTOPERATIVE PAIN RELIEF IN THORACOTOMY PATIENTS

Abstract

Objectives: The aim of this study is to determine whether thoracic epidural
analgesia with bupivacaine is better than intravenous narcotic analgesia for pain relief in
thoracotomy patients. Study design: Prospective randomized study. Setting: Department of
Thoracic Surgery, Ojha Institute of Chest Diseases and Dow University of Health Sciences.
Period: May 2014- Nov 2015. Methods: 144 patients were allocated randomly into 2 Groups.
Group A received thoracic epidural analgesia with bupivacaine and Group B received intravenous
narcotic analgesia with tramadol. Pain was monitored in both groups using the VAS pain scale
every hour for the first 6 hours and then at 20, 24, 30, and 48 hours postoperatively. Results: It
was observed that Group A patients experienced less pain at rest, coughing and on movements
as compared to patients in Group B throughout the monitoring from first hour to 48 hours
postoperatively. There was no significant difference between the groups in respiratory rate, O2
saturation, adverse effects and performance status on day one and day two postoperatively.
The mean hospital stay after operation was 7 days in both groups. Conclusions: Optimal pain
relief after thoracotomy improves patient recovery and satisfaction. We determined that thoracic
epidural analgesia with bupivacaine is better than intravenous narcotic analgesia for pain relief
in thoracotomy patients.