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Eur J Cardiothorac Surg 2003;24:420-424
© 2003 Elsevier Science NL

Early postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural analgesia: a randomised study

^a Department of Anaesthesiology, Akdeniz University Medical Faculty, Antalya, Turkey
^b Department of Thoracic Surgery, Akdeniz University Medical Faculty, Antalya, Turkey

Received 6 March 2003; received in revised form 18 May 2003; accepted 26 May 2003.

^* Corresponding author. Tel.: +90-242-227-4343; fax: +90-242-227-8836
e-mail: ayegin{at}ixir.com

Objectives: Effective analgesia and blockade of the perioperative stress response may improve outcome and epidural analgesia plays a role in the reduction of pulmonary complications following thoracic surgery. In this study, we assessed preoperative and postoperative thoracic epidural analgesia (Preop-TEA and Postop-TEA) techniques on post-thoracotomy pain in 61 patients undergoing posterolateral thoracotomy. Methods: A thoracic epidural catheter was inserted into all the patients before surgery. In Group I, 8 mL of 0.25% bupivacaine plus fentanyl 50 µg in 2 mL was administered preoperatively. In Group II, no medication was administered via the epidural catheter preoperatively and intraoperatively. Postoperative analgesia was maintained with patient-controlled epidural analgesia with bupivacaine and fentanyl solution in both groups. Pain was evaluated at 2, 4, 8, 12, 24 and 48 h at rest and coughing. Results: Preop-TEA Group was associated with decreased pain compared with the Postop-TEA Group. Conclusions: In conclusion, preoperative epidural analgesia is an appropriate method for post-thoracotomy pain and is more effective in preventing acute postoperative pain.

Key Words: Analgesia • Epidural • Thoracotomy • Pain • Postoperative

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