ISSN: 1859 - 2872
Comparison of analgesic effect by patient controlled epidural analgesia with paravertebral after complete video-assisted thoracoscopic surgery lobectomy
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Abstract
Objective: To compare the effect of patient controlled epidural analgesia with paravertebral technique by bupivacaine 0.1% combine fentanyl 2mg/ml after complete video-assisted thoracoscopic surgery lobectomy. Subject and method: A prospective study of 40 patients divided into 2 random groups: PCTEA group of 20 patients controlled thoracic epidural analgesia with bupivacaine 0.1% + fentanyl 2mg/ml, PCTPA group of 20 patients controlled thoracic paravertebral analgesia with bupivacaine 0.1% + fentanyl 2mg/ml. In the both groups, an initial dose of 2ml/kg of 1% lidocaine was administered, followed by a 4 - 7ml/h bupivacaine 0.1% + fentanyl 2mg/ml continuous infusion with patient-controlled analgesia (3ml bolus, 30-minute lockout interval). Evaluate pain level according to VAS scale at rest and on coughing; monitor pulse, blood pressure, breathing frequency, SpO2 for 3 days after surgery. Result: Postoperative analgesic effects in both methods were effective, mean VAS score of the PCTPA group and the PCTEA group were low both at rest and on coughing in 72 hours of pain relief (p>0.05). The number of bolus in PCTEA group (14 times) was not significantly lower than that of PCTPA group (16 times), p>0.05. The side effect of paravertebral group less than epidural groups controlled by patients after complete video-assisted thoracoscopic surgery lobectomy (p>0.05). Conclusion: Postoperative analgesic effects of patient controlled epidural analgesia and paravertebral by 0.1% bupivacaine combine fentanyl 2mg/ml has high analgesic effect and side effects of paravertebral group less than epidural groups controlled by patients after complete video-assisted thoracoscopic surgery lobectomy (p>0.05).
Keywords: Patient controlled analgesia, epidural, paravertebral, complete video-assisted thoracoscopic surgery lobectomy
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References
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