PURPOSE: Although Thoracic Epidural Analgesia (TEA) is the gold standard treatment for relieving of post thoracotomy pain in the reference books but there are several fatal potential complications and technical problems that limited its using. Some surgeons recently have reported extra pleural Para vertebral catheter analgesia (PARA) as an alternative method.In this perspective, randomized, controlled trial study a comparison was performed between analgesic effects of these methods together and with systemic morphine administration analgesia in 45 post thoracotomy patients.
METHODS: In this perspective, randomized, controlled trial study a comparison was performed between analgesic effects of these methods together and with systemic morphine administration analgesia in 45 post thoracotomy patientsIn TEA group, catheter inserted before beginning of operation and 100mg diluted petedine injected just before of general anesthesia and then repeated every 8 hours until 72 hours post operative time with 50mg petedine. In PARA group, when surgeon wanted to closed chest wall a catheter placed in extera pleural para vertebral place just near to thoracotomy incision, after ending of operation 10ml bupivacaine 0.25% in 1:200,000 epinephrine injected via this catheter and repeated every 8 hours till 72 hours post operative.In morphine group, 5mg diluted morphine injected intravenously every 6 hours till 3 days.Pain was assessed by a linear visual analog scale (VAS) pain score every 6 hours and then data analyzed with treatment VS control and repeated measurement method.
RESULTS: According to this study both PARA and TEA provided good pain control without significant difference (P value <0.071) but they were significantly superior to systemic morphine group (P value<0.001, P value<0.001). Incidence of pain related complication hadn’t significant difference between groups.
CONCLUSION: Extra plural para vertebral analgesia is a safe method of post thorctomy analgesia.
CLINICAL IMPLICATIONS: Extra plural para vertebral analgesia is a safe method of post thorctomy analgesia.
DISCLOSURE: Hamid Hemmati, None.