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首页> 外文期刊>Acute pain: international journal of acute pain management >Epidural methadone for acute post-thoracotomy pain: An alternative to a ropivacaine plus fentanyl-based patient-controlled epidural regimen
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Epidural methadone for acute post-thoracotomy pain: An alternative to a ropivacaine plus fentanyl-based patient-controlled epidural regimen

机译：硬膜外美沙酮治疗急性开胸术后疼痛：罗哌卡因加以芬太尼为基础的患者自控硬膜外疗法的替代方案

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摘要

Accurate management of acute post-thoracotomy pain can be obtained with epidural local anaesthetics with or without opioids. The routine in our centre for many years has been boluses of epidural methadone with satisfactory results and a lack of serious complication. Objectives To compare the analgesic effectiveness of two epidural regimens for acute post-thoracotomy pain management. Methods We enrolled 49 patients undergoing lung resection by thoracotomy in a prospective, non-blinded open study. Study groups: 25 patients received a patient controlled epidural (PCEA) regimen of 0.16% ropivacaine plus 3.5mugml~(-1) fentanyl, and the other 24 patients receiving 4-6 mg of epidural boluses of 0.1% methadone every 8h. Results Both regimens provided similar pain relief during the first two postoperative days, however, patients receiving methadone needed less rescue analgesia and presented fewer numbers of hypotensive events compared to PCEA patients. Conclusions Epidural boluses of methadone are as a safe andadequate analgesic regiment as a PCEA with ropivacaine plus fentanyl for post-thoracotomy pain management. Additionally, the cost of our current technique is much lower than the ropivacaine infusion.
机译：硬膜外局部麻醉药（有或没有阿片类药物）可实现对急性开胸术后疼痛的准确处理。多年来，我们中心的常规做法是大剂量硬膜外注射美沙酮，但没有严重的并发症。目的比较两种硬膜外疗法对开胸术后急性疼痛的镇痛效果。方法我们在一项前瞻性，非盲的开放性研究中纳入了49例行开胸肺切除术的患者。研究组：25例患者接受了0.16％罗哌卡因加3.5 ugml〜（-1）芬太尼的硬膜外自控（PCEA）方案，其他24例患者每8h接受4-6 mg 0.1％美沙酮的硬膜外大剂量治疗。结果两种方案在术后的前两天都提供了类似的止痛效果，但是，与PCEA患者相比，接受美沙酮治疗的患者需要较少的急救镇痛作用，并且出现较少的降压事件。结论：与罗哌卡因联合芬太尼的PCEA相比，美沙酮硬膜外大剂量镇痛药是一种安全，充分的镇痛方法。另外，我们当前技术的成本比罗哌卡因输注低得多。

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