Effects of Preoperatively or Postoperatively Initiated Thoracic Epidural Analgesia in Patients Undergoing Elective Lung Surgery

Abstract

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: :The go al of this study was to in ves ti ga te the ef fects of pre o pe ra ti vely and pos tope ra ti vely ini ti a ted tho ra cic epi du ral anal ge si a (TE A) on oxi da ti ve stress, res pi ra tory func ti ons and pos to pe ra ti ve pa in in pa ti ents un der go ing elec ti ve lung sur gery. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : A tho ra cic epi du ral cat he ter was in ser ted in to all the pa ti ents be fo re sur gery. In Pre op-TE A Gro up (n= 15), bo lus do se of 0.175% bu pi va ca i ne and 15 µg ml -1 fen tanyl (0.1 ml kg -1 ) were ad mi nis te red pre o pe ra ti vely, fol lo wed by a con ti nu o us in fu si on of 0.125% bu pi va ca i ne and 10 µg ml -1 fen tanyl com bi na ti on (0.1 ml kg -1 h -1 ) in trao pe ra ti vely. In Pos top-TE A Gro up (n= 15), no me di ca ti on was ad mi nis te red vi a the epi du ral cat he ter pre o pe ra ti vely. Pos to pe ra ti ve anal ge si a was ma in ta i ned with pa ti ent-con trol led epi du ral anal ge si a (PCA) in both gro ups for 48 h. We as ses sed pe ro pe ra ti ve IV anal ge sic re qu irt ment and pos to pe ra ti ve pa in and anal ge sic con sump ti on, oxi da ti ve stress, he art ra te, blo od pres su re, res pi ra tory func ti ons and si de ef fects. The pos to pe ra ti ve in ten si ve ca re unit and hos pi tal stay du ra ti ons we re re cor ded. Stu dent's t-test, χ 2 -test, Mann-Whit ney U test, and Wil co xon's sig ned rank test we re used for gro up com pa ri sons and sta tis ti cal conc lu si ons. R Re e s su ul lt ts s: : Vi su al ana lo gu e sco res we re al ways hig her du ring co ug hing and at rest, pe ri o pe rati ve he art ra te was increased in Pos top-TE A Gro up (p< 0.05). To tal pe ro pe ra ti ve fen tanyl re qu i re ment and pos to pe ra ti ve anal ge sic con sump ti on vi a PCA we re lo wer in Pre op-TE A Gro up (p< 0.05). Res pi ra tory func ti on tests we re dec re a sed in both gro ups when com pa red to the pre o pe ra ti ve va lu es (p< 0.05), but the dif fe ren ces we re small in Preop-TEA group (p< 0.05). No mar ked ef fect on oxi da ti ve stress was determined and shor ter length of stay in ICU and hos pi tal shorter in Pre op-TE A Gro up (p< 0.05). C Co on nc c l lu u s si i o on n: : The se re sults sug gest that pre o pe ra ti vely ini ti a ted TE A pro vi des bet ter pos to pe ra ti ve pa in re li ef with impro ving the out co me and shor te ning in ten si ve ca re and hos pi tal stay in pa ti ents un der go ing elec ti ve lung sur gery. Ho we ver, TE A had no mar ked ef fect on oxi da ti ve stress in our study. K Ke ey y W Wo or rd ds s: : Anal ge si a, epi du ral; tho ra co tomy; pa in, pos to pe ra ti ve; oxi da ti ve stress Ö ÖZ ZE ET T A Am ma aç ç: : Bu ça lış ma nın ama cı elek tif ak ci ğer cer ra hi si olan has ta lar da ok si datif stress, so lu num fonksi yon la rı ve pos to pe ra tif ağ rı üze ri ne pre o pe ra tif ve pos to pe ra tif baş la tı lan to ra sik epi du ral anal je zi nin (TE A) et ki le ri ni araş tır mak tı. G Ge er re eç...

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