Value of prolonged epidural analgesia in thoracic surgery

The use of high thoracic epidurals for post-thoracotomy pain relief in 156 patients is reviewed. Analgesia was maintained with a continuous infusion of a local anaesthetic, bupivacaïne 0.5% 40 ml, mixed with a narcotic, fentanyl 10 ml (perfusion rate between 3 and 7 ml/h). There was successful analg...

Full description

Saved in:
Bibliographic Details
Published inAnnales de chirurgie Vol. 43; no. 2; p. 181
Main Authors Quinot, J F, Houdelette, P, Coquelin, G, Courtière, P, Donnard, G, Rouvin, B, Saissy, J M, Chateau, J
Format Journal Article
LanguageFrench
Published France 1989
Subjects
Analgesia, Epidural
Bupivacaine - administration & dosage
Fentanyl - administration & dosage
Humans
Postoperative Period
Thoracic Surgery
Online AccessGet more information

Cover

More Information
Summary:The use of high thoracic epidurals for post-thoracotomy pain relief in 156 patients is reviewed. Analgesia was maintained with a continuous infusion of a local anaesthetic, bupivacaïne 0.5% 40 ml, mixed with a narcotic, fentanyl 10 ml (perfusion rate between 3 and 7 ml/h). There was successful analgesia in 92%, with efficient ventilation, effective cough, no respiratory distress and only 8 cases of fibroaspiration. Only two significant respiratory complications occurred, due to incorrect management of the peridural route: the analgesic mixture was too concentrated and was injected by bolus instead of by continuous infusion. Other complications occurred, 8 cases of nausea or pruritus, 4 hallucinations, 10 cases of urinary retention lasting more than 24 h, 14 superior limb palsies and 22 Horner's oculopapillary syndrome. All of these complications were minor, easy to manage, and resolved after stopping peridural infusion. In conclusion, peridural analgesia is highly effective and improves the atmosphere in post-thoracotomy wards.
ISSN:0003-3944