Thoracic epidural analgesia or patient-controlled local analgesia for radical retropubic prostatectomy: a randomized, double-blind study.
Br J Anaesth
; 107(5): 782-9, 2011 Nov.
Article
em En
| MEDLINE
| ID: mdl-21948951
ABSTRACT
BACKGROUND:
Postoperative pain after radical retropubic prostatectomy is moderate to severe. The primary aim of this study was to assess whether intra-abdominal local anaesthetics provide similar analgesia compared with thoracic epidural analgesia (TEA).METHODS:
Fifty patients, ASA I-II, participated in this prospective, double-blinded study. All patients had TEA. After operation, they were randomized into two groups of 25 patients Group PCLA (patient-controlled local analgesia) self-administration of 10 ml of ropivacaine 2 mg ml⻹ via the intra-abdominal catheter for 48 h. Group TEA infusion of 10 ml h⻹ of ropivacaine 1 mg ml⻹, fentanyl 2 µg ml⻹, and epinephrine 2 µg ml⻹ epidurally for 48 h. The primary endpoint was pain on coughing at 4 h after operation. Rescue medication was morphine i.v. as required.RESULTS:
Pain on coughing at 4, 24, and 48 h was significantly lower in Group TEA [0 (0-10)] compared with Group PCLA [4 (0-10)] (P<0.05). Significantly lower pain intensity was also found in Group TEA compared with Group PCLA at the incision site, deep pain, and pain on coughing at 4 and 24 h (P<0.05). Morphine consumption was significantly greater in Group PCLA [12 (0-46)] compared with Group TEA [0 (0-20)] at 0-48 h after operation [median (range)] (P=0.015). Maximum expiratory pressure was higher in Group TEA compared with Group PCLA at 24 h (P<0.01).CONCLUSIONS:
TEA provides superior postoperative pain relief with better preservation of expiratory muscle strength compared with PCLA.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Observational_studies
Limite:
Aged
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article