Skip Navigation



BJA Advance Access published online on March 19, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh129
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
92/5/670    most recent
aeh129v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Tan, C. N. H.
Right arrow Articles by Russell, G. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tan, C. N. H.
Right arrow Articles by Russell, G. N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Accepted December 13, 2003

Clinical Investigation

Optimal concentration of epidural fentanyl in bupivacaine 0.1% after thoracotomy

C. N. H. Tan 1, A. Guha 2, N. D. A. Scawn 3, S. H. Pennefather 3*, G. N. Russell 3

1 Department of Anaesthesia, The Cardiothoracic Centre, Liverpool, Thomas Drive, Liverpool L14 3PE, UK; Department of Anaesthesia, University Hospitals of Wales, Heath Park, Cardiff CF14 4WX, UK
2 Department of Anaesthesia, The Cardiothoracic Centre, Liverpool, Thomas Drive, Liverpool L14 3PE, UK; Department of Anaesthesia, University Hospital Aintree, Longmoor Lane, Liverpool L9 7A, UK
3 Department of Anaesthesia, The Cardiothoracic Centre, Liverpool, Thomas Drive, Liverpool L14 3PE, UK

* To whom correspondence should be addressed. E-mail: stephen.pennefather{at}ctc.nhs.uk.


  Abstract

Background. The aim of this prospective, double-blind, randomized controlled trial was to investigate the analgesic and adverse effects of three commonly used concentrations of thoracic epidural fentanyl with bupivacaine in patients undergoing thoracotomy for lung resection.

Methods. We studied 99 patients who were randomized to receive fentanyl 2 µg ml-1 (group 2), fentanyl 5 µg ml-1 (group 5) and fentanyl 10 µg ml-1 (group 10) in bupivacaine 0.1% via a thoracic epidural. Postoperatively, pain on coughing was assessed using a visual analogue scale (VAS) and an observer verbal rating score (OVRS) at 2, 8, 16 and 24 h. At the same times, sedation, pruritus and nausea were assessed.

Results. Of 29, 28 and 32 patients who completed the study in groups 2, 5 and 10 respectively, there was no significant difference in baseline characteristics between the three groups. The number of patients with episodes of unsatisfactory pain, i.e. VAS scores >30 mm and OVRS >1, at each of the four assessments postoperatively was significantly (P<0.01) higher in group 2 than in groups 5 and 10. In group 10, 16 patients had sedation scores >1 compared with 10 each in groups 2 and 5. In addition, 19 patients in group 10 experienced pruritus compared with 12 each, in groups 2 and 5. These differences were not significant. Nausea was not significantly different between the three groups.

Conclusion. We conclude that thoracic epidural fentanyl 5 µg ml-1 with bupivacaine 0.1% provides the optimum balance between pain relief and side effects following thoracotomy.

Keywords: Keywords: anaesthesia, regional; anaesthetic techniques, thoracic epidural; analgesics opioid, fentanyl; surgery, thoracotomy


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Br J AnaesthHome page
I. McGovern, C. Walker, F. Cox, A. Ng, and J. Swanevelder
Pain relief after thoracotomy
Br. J. Anaesth., June 1, 2007; 98(6): 844 - 845.
[Full Text] [PDF]

Home page
 Br J AnaesthHome page
A. Ng and J. Swanevelder
Pain relief after thoracotomy: is epidural analgesia the optimal technique?
Br. J. Anaesth., February 1, 2007; 98(2): 159 - 162.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.