Prospective, Comparative Study of the On-Q® PainBuster® Postoperative Pain Relief System and Thoracic Epidural Analgesia After Thoracic Surgery
| Autor: | Tamas Szöke, Michael Ried, Hans-Stefan Hofmann, Andrea Rupp, Tobias Potzger, Karl-Peter Ittner, Claudius Diez, Christian Schilling |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Pilot Projects Thoracic Vertebrae Pulmonary function testing Thoracic epidural Postoperative pain relief medicine Humans Ropivacaine In patient Prospective Studies Thoracotomy Anesthetics Local Lung cancer Pain Postoperative Dose-Response Relationship Drug business.industry Analgesia Patient-Controlled Middle Aged Thoracic Surgical Procedures medicine.disease Amides Bupivacaine Respiratory Function Tests Surgery Analgesia Epidural Treatment Outcome Anesthesiology and Pain Medicine Cardiothoracic surgery Anesthesia Female Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 28:973-978 |
| ISSN: | 1053-0770 |
| Popis: | Objective Pain after thoracotomy is associated with intense discomfort leading to impaired pulmonary function. Design Prospective, non-randomized trial from April 2009 to September 2011. Setting Department of Thoracic Surgery, single-center. Participants Thoracic surgical patients. Interventions Comparison of thoracic epidural analgesia (TEA) with the On-Q® PainBuster® system after thoracotomy. Measurements and Main Results The TEA group (n = 30) received TEA with continuous 0.2% ropivacaine at 4 mL-to-8 mL/h, whereas Painbuster® patients (n = 32) received 0.75% ropivacaine at 5 mL/h until postoperative day 4 (POD4). Basic and on-demand analgesia were identical in both groups. Pain was measured daily on a numeric analog scale from 0 (no pain) to 10 (worst pain) at rest and at exercise. There were no significant differences regarding demographic and preoperative data between the groups, but PainBuster® patients had a slightly lower relative forced expiratory volume in 1 second (FEV1) (71±20% versus 86±21%; p = 0.01). Most common surgical procedures were lobectomies (38.8%) and atypical resections (28.3%) via anterolateral thoracotomy. Most common primary diagnoses were lung cancer (48.3%) and tumor of unknown origin (30%). At POD1, median postoperative pain at rest was 2.1 (1; 2.8) in the TEA group and 2 (1.5; 3.8; p = 0.62) in the PainBuster® group. At exercise, median pain was 4.3 (3.5; 3.8) in the TEA group compared to 5.0 (4.0; 6.5; p = 0.07). Until POD 5 there were decreases in pain at rest and exercise but without significant differences between the groups. Conclusions Sufficient analgesia after thoracotomy can be achieved with the intercostal PainBuster® system in patients, who cannot receive TEA. |
| Databáze: | OpenAIRE |
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