Author/Editor     Lopuh, M; Paver-Eržen, V; Strauch, L; Oberauner, L; Jankovič, V; Rink, N; Gomzi, B; Grmič, M; Modrijan, I; Kočan, B
Title     Influence of thoracic epidural analgesia on lung function after lung surgery: a comparison of ropivacaine with a mixture of bupivacaine, morphine and clonidine
Type     članek
Source     In: Zabavnik Z, editor. Book of lectures of the 16th anaesthesia symposium Alpe Adria; 2003 May 9-11; Maribor. Maribor: Splošna bolnišnica,
Publication year     2003
Volume     str. 201-8
Language     eng
Abstract     The present study compared analgesic efficacy of epidural ropivacaine (group A) with epidural mixture of 10 mg of morphine, 50 mg of 0.5 % bupivacaine and 150 mcg of clonidine (group B) in 37 patients, who underwent lung surgery. Patients were randomized in a double blind manner to receive a continouos epidural infusion (PCEA) by thoracic epidural catheter. PCEA was started one hour before the end of surgery. Spirometric measurements were performed 4 hours after surgery and on the two consecutive days. Pain scores at rest and during spirometry, pain relief scores, consumption of rescue analgesics, haemodynamic stabiliiy, motor blockade and side effects (nausea, vomiting, sedation, pruritus, obstipation, urinary retention) were assesed. There was no significant difference between both groups in spirometry although there was tendency for better values in the ropivacaine group. Pain scores were comparable in both groups, consumption of rescue analgesics was bigger in B group. Patients in B group had significantly more side effects than A group. There was no significant difference in motor blockade. We conclude that epidural infusion of ropivacaine in combination with additional boli (PCEA) and rescue analgesics (nonsteroidal antiinflammatory drugs) offers good quality of analgesia after lobectomy. A larger group of patients will be needed to prove if there is indeed a difference in spirometric measurements.
Descriptors     ANALGESIA, EPIDURAL
PNEUMONECTOMY
SPIROMETRY
BUPIVACAINE
MORPHINE
CLONIDINE
PAIN MEASUREMENT