High vs mid thoracic epidural analgesia - A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies.
Ann Card Anaesth
; 22(4): 383-387, 2019.
Article
in En
| MEDLINE
| ID: mdl-31621673
ABSTRACT
Background:
Thoracic epidural analgesia offers effective perioperative pain relief in patients undergoing thoracotomies apart from attenuating stress responses. It helps in fast tracking by facilitating early mobilization and improving respiratory function. Literature on high (T1-T2 level) thoracic segmental analgesia for thoracotomy is less.Aim:
The aim of present study was to compare the ease of insertion, effect on pain relief in high (T1-T2 level) vs mid (T5-T6) approach of thoracic epidural. Setting andDesign:
The present study was a randomized control trial conducted at our institute. Materials andMethods:
About 52 patients aged between 18-65 years scheduled for elective thoracotomies under general and thoracic epidural anesthesia were randomized into two groups. Intraoperatively ease of epidural insertion, extent of blockade, and postoperatively pain relief were assessed. Ropivacaine with fentanyl was used for epidural analgesia. StatisticalAnalysis:
Data were presented as mean ± standard deviation and analyzed by the Student's t test, Chi-square test, and non-parametric test whereever applicable. A P value <0.05 was considered statistically significant.Results:
We observed that high thoracic epidural anesthesia was easier to place (time taken 123.42 vs 303.08 s) P < 0.05, with less number of attempts (1.27 vs 1.92) P < 0.05. Extent of blockade, postoperative pain scores, rescue analgesia requirement, hemodynamics, and oxygenation were comparable.Conclusion:
We conclude that high thoracic epidural is easier to insert, provides adequate pain relief, and stable hemodynamics with the advantage of patient comfort and safety.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Oxygen Consumption
/
Thoracotomy
/
Analgesia, Epidural
/
Pain Management
/
Hemodynamics
Type of study:
Clinical_trials
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Ann Card Anaesth
Year:
2019
Document type:
Article
Affiliation country:
India