Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802016000400280 |
Resumo: | ABSTRACT CONTEXT AND OBJECTIVE: Post-thoracotomy pain is a severe and intense pain caused by trauma to ribs, muscles and peripheral nerves. The current study aimed to compare subpleural analgesia (SPA) with thoracic epidural analgesia (TEA) in patients undergoing thoracotomy. DESIGN AND SETTING: Randomized study at Ankara Numune Education and Research Hospital, in Turkey. METHODS: Thirty patients presenting American Society of Anesthesiologists physical status I-III were scheduled for elective diagnostic thoracotomy. The patients were randomized to receive either patient-controlled SPA or patient-controlled TEA for post-thoracotomy pain control over a 24-hour period. The two groups received a mixture of 3 µg/ml fentanyl along with 0.05% bupivacaine solution through a patient-controlled analgesia pump. Rescue analgesia was administered intravenously, consisting of 100 mg tramadol in both groups. A visual analogue scale was used to assess pain at rest and during coughing over the course of 24 hours postoperatively. RESULTS: In the SPA group, all the patients required rescue analgesia, and five patients (33%) required rescue analgesia in the TEA group (P < 0.05). Patients who received subpleural analgesia exhibited higher visual analogue scores at rest and on coughing than patients who received thoracic epidural analgesia. None of the patients had any side-effects postoperatively, such as hypotension or respiratory depression. CONCLUSION: Thoracic epidural analgesia is superior to subpleural analgesia for relieving post-thoracotomy pain. We suggest that studies on effective drug dosages for providing subpleural analgesia are necessary. |
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São Paulo medical journal (Online) |
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Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trialpain, postoperativeanalgesia, epiduralpleurathoracotomyanalgesia, patient-controlledABSTRACT CONTEXT AND OBJECTIVE: Post-thoracotomy pain is a severe and intense pain caused by trauma to ribs, muscles and peripheral nerves. The current study aimed to compare subpleural analgesia (SPA) with thoracic epidural analgesia (TEA) in patients undergoing thoracotomy. DESIGN AND SETTING: Randomized study at Ankara Numune Education and Research Hospital, in Turkey. METHODS: Thirty patients presenting American Society of Anesthesiologists physical status I-III were scheduled for elective diagnostic thoracotomy. The patients were randomized to receive either patient-controlled SPA or patient-controlled TEA for post-thoracotomy pain control over a 24-hour period. The two groups received a mixture of 3 µg/ml fentanyl along with 0.05% bupivacaine solution through a patient-controlled analgesia pump. Rescue analgesia was administered intravenously, consisting of 100 mg tramadol in both groups. A visual analogue scale was used to assess pain at rest and during coughing over the course of 24 hours postoperatively. RESULTS: In the SPA group, all the patients required rescue analgesia, and five patients (33%) required rescue analgesia in the TEA group (P < 0.05). Patients who received subpleural analgesia exhibited higher visual analogue scores at rest and on coughing than patients who received thoracic epidural analgesia. None of the patients had any side-effects postoperatively, such as hypotension or respiratory depression. CONCLUSION: Thoracic epidural analgesia is superior to subpleural analgesia for relieving post-thoracotomy pain. We suggest that studies on effective drug dosages for providing subpleural analgesia are necessary.Associação Paulista de Medicina - APM2016-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802016000400280Sao Paulo Medical Journal v.134 n.4 2016reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2015.00462405info:eu-repo/semantics/openAccessTezcan,Aysu HayriyeKarakurt,ÖzgürEryazgan,Mehmet AliBaşkan,SemihÖrnek,Dilşen HaticeBaldemir,RamazanKoçer,BülentBaydar,Mustafaeng2016-08-18T00:00:00Zoai:scielo:S1516-31802016000400280Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2016-08-18T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial |
title |
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial |
spellingShingle |
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial Tezcan,Aysu Hayriye pain, postoperative analgesia, epidural pleura thoracotomy analgesia, patient-controlled |
title_short |
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial |
title_full |
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial |
title_fullStr |
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial |
title_full_unstemmed |
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial |
title_sort |
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial |
author |
Tezcan,Aysu Hayriye |
author_facet |
Tezcan,Aysu Hayriye Karakurt,Özgür Eryazgan,Mehmet Ali Başkan,Semih Örnek,Dilşen Hatice Baldemir,Ramazan Koçer,Bülent Baydar,Mustafa |
author_role |
author |
author2 |
Karakurt,Özgür Eryazgan,Mehmet Ali Başkan,Semih Örnek,Dilşen Hatice Baldemir,Ramazan Koçer,Bülent Baydar,Mustafa |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Tezcan,Aysu Hayriye Karakurt,Özgür Eryazgan,Mehmet Ali Başkan,Semih Örnek,Dilşen Hatice Baldemir,Ramazan Koçer,Bülent Baydar,Mustafa |
dc.subject.por.fl_str_mv |
pain, postoperative analgesia, epidural pleura thoracotomy analgesia, patient-controlled |
topic |
pain, postoperative analgesia, epidural pleura thoracotomy analgesia, patient-controlled |
description |
ABSTRACT CONTEXT AND OBJECTIVE: Post-thoracotomy pain is a severe and intense pain caused by trauma to ribs, muscles and peripheral nerves. The current study aimed to compare subpleural analgesia (SPA) with thoracic epidural analgesia (TEA) in patients undergoing thoracotomy. DESIGN AND SETTING: Randomized study at Ankara Numune Education and Research Hospital, in Turkey. METHODS: Thirty patients presenting American Society of Anesthesiologists physical status I-III were scheduled for elective diagnostic thoracotomy. The patients were randomized to receive either patient-controlled SPA or patient-controlled TEA for post-thoracotomy pain control over a 24-hour period. The two groups received a mixture of 3 µg/ml fentanyl along with 0.05% bupivacaine solution through a patient-controlled analgesia pump. Rescue analgesia was administered intravenously, consisting of 100 mg tramadol in both groups. A visual analogue scale was used to assess pain at rest and during coughing over the course of 24 hours postoperatively. RESULTS: In the SPA group, all the patients required rescue analgesia, and five patients (33%) required rescue analgesia in the TEA group (P < 0.05). Patients who received subpleural analgesia exhibited higher visual analogue scores at rest and on coughing than patients who received thoracic epidural analgesia. None of the patients had any side-effects postoperatively, such as hypotension or respiratory depression. CONCLUSION: Thoracic epidural analgesia is superior to subpleural analgesia for relieving post-thoracotomy pain. We suggest that studies on effective drug dosages for providing subpleural analgesia are necessary. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802016000400280 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802016000400280 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-3180.2015.00462405 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.134 n.4 2016 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209264856989696 |