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首页> 外文期刊>Sao Paulo Medical Journal >Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial
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Post-thoracotomy pain relief with subpleural analgesia or thoracic epidural analgesia: randomized clinical trial

机译：胸膜下镇痛或胸膜硬膜外镇痛的开胸术后疼痛缓解：随机临床试验

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ABSTRACTCONTEXT AND OBJECTIVE: 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.DESIGN AND SETTING: Randomized study at Ankara Numune Education and Research Hospital, in Turkey.METHODS: 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.RESULTS: 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.CONCLUSION: 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.
机译：摘要背景和目的：开胸术后疼痛是由肋骨，肌肉和周围神经的创伤引起的严重而剧烈的疼痛。目前的研究旨在比较接受开胸手术的患者的胸膜下镇痛（SPA）和胸膜硬膜外镇痛（TEA）。设计和设置：土耳其安卡拉努姆纳教育与研究医院的随机研究方法：30名患者向美国麻醉医师学会状态I-III计划进行选择性诊断性开胸手术。患者被随机分配接受患者控制的SPA或患者控制的TEA，以在24小时内控制开胸术后的疼痛。两组通过患者控制的镇痛泵接受3μg/ ml芬太尼与0.05％布比卡因溶液的混合物。两组均使用100 mg曲马多静脉内进行镇痛镇痛。结果：SPA组中，所有患者均需要抢救镇痛，而TEA组中5例患者（33％）需要抢救镇痛;采用视觉模拟量表评估术后24小时静息和咳嗽时的疼痛。 （P ＜0.05）。接受胸膜下镇痛的患者在静息和咳嗽时的视觉模拟评分均高于接受胸膜硬膜外镇痛的患者。结论：胸膜硬膜外镇痛优于胸膜下镇痛可减轻开胸术后的疼痛，无一例患者出现术后副作用，如低血压或呼吸抑制。我们建议对提供胸膜下镇痛的有效药物剂量进行研究是必要的。

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