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Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial.

Overview of attention for article published in Sao Paulo Medical Journal, November 2015
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Title
Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial.
Published in
Sao Paulo Medical Journal, November 2015
DOI 10.1590/1516-3180.2015.00462405
Pubmed ID
Authors

Tezcan, Aysu Hayriye, Karakurt, Özgür, Eryazgan, Mehmet Ali, Başkan, Semih, Örnek, Dilşen Hatice, Baldemir, Ramazan, Koçer, Bülent, Baydar, Mustafa, Aysu Hayriye Tezcan, Özgür Karakurt, Mehmet Ali Eryazgan, Semih Başkan, Dilşen Hatice Örnek, Ramazan Baldemir, Bülent Koçer, Mustafa Baydar

Abstract

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. Randomized study at Ankara Numune Education and Research Hospital, in Turkey. 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. 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. 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.

Mendeley readers

The data shown below were compiled from readership statistics for 3 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 3 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 2 67%
Other 1 33%
Readers by discipline Count As %
Medicine and Dentistry 2 67%
Psychology 1 33%