Pain relief after esophagectomy: Thoracic epidural analgesia is better than parenteral opioids
(2001) In Journal of Cardiothoracic and Vascular Anesthesia 15(3). p.282-287- Abstract
- OBJECTIVE: To compare postoperative pain relief and pulmonary function in patients after thoracoabdominal esophagectomy treated by continuing perioperative thoracic epidural anesthesia or changing to parenteral opioids. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. PARTICIPANTS: Thirty-three patients undergoing thoracoabdominal esophagectomy. INTERVENTIONS: General anesthesia was combined with thoracic epidural anesthesia during surgery. The patients either continued with thoracic epidural analgesia (n = 18) or were switched to patient-controlled analgesia with intravenous morphine (n = 15) for 5 postoperative days. Pain scores were estimated twice daily, at rest and after mobilization. Peak expiratory flow,... (More)
- OBJECTIVE: To compare postoperative pain relief and pulmonary function in patients after thoracoabdominal esophagectomy treated by continuing perioperative thoracic epidural anesthesia or changing to parenteral opioids. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. PARTICIPANTS: Thirty-three patients undergoing thoracoabdominal esophagectomy. INTERVENTIONS: General anesthesia was combined with thoracic epidural anesthesia during surgery. The patients either continued with thoracic epidural analgesia (n = 18) or were switched to patient-controlled analgesia with intravenous morphine (n = 15) for 5 postoperative days. Pain scores were estimated twice daily, at rest and after mobilization. Peak expiratory flow, forced expiratory volume, and vital capacity were measured the day before surgery, postoperative day 2, and postoperative day 6. Adverse events and complications were recorded. MEASUREMENTS AND MAIN RESULTS: At rest, there were no differences in pain relief between the groups. Pain scores at mobilization showed a significantly lower value in the epidural group (p < 0.027). No intergroup differences were found regarding pulmonary function, which decreased on postoperative day 2, but was improved on postoperative day 6. CONCLUSION: Continuation of intraoperative thoracic epidural anesthesia for 5 postoperative days provides better pain relief at mobilization compared with a switch to patient-controlled analgesia with intravenous morphine. There was no intergroup difference in the impact on measures of pulmonary function. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1120200
- author
- Flisberg, Per LU ; Törnebrandt, Kenneth ; Walther, Bruno LU and Lundberg, Johan LU
- organization
- publishing date
- 2001
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- intravenous analgesia, thoracic epidural, esophagectomy, postoperative, morphine, bupivacaine
- in
- Journal of Cardiothoracic and Vascular Anesthesia
- volume
- 15
- issue
- 3
- pages
- 282 - 287
- publisher
- Elsevier
- external identifiers
-
- pmid:11426356
- scopus:0034987741
- pmid:11426356
- ISSN
- 1532-8422
- DOI
- 10.1053/jcan.2001.23270
- language
- English
- LU publication?
- yes
- id
- 39370814-51e6-4faf-8fa8-54e1bdce7b76 (old id 1120200)
- date added to LUP
- 2016-04-01 12:30:36
- date last changed
- 2022-01-27 06:05:17
@article{39370814-51e6-4faf-8fa8-54e1bdce7b76, abstract = {{OBJECTIVE: To compare postoperative pain relief and pulmonary function in patients after thoracoabdominal esophagectomy treated by continuing perioperative thoracic epidural anesthesia or changing to parenteral opioids. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. PARTICIPANTS: Thirty-three patients undergoing thoracoabdominal esophagectomy. INTERVENTIONS: General anesthesia was combined with thoracic epidural anesthesia during surgery. The patients either continued with thoracic epidural analgesia (n = 18) or were switched to patient-controlled analgesia with intravenous morphine (n = 15) for 5 postoperative days. Pain scores were estimated twice daily, at rest and after mobilization. Peak expiratory flow, forced expiratory volume, and vital capacity were measured the day before surgery, postoperative day 2, and postoperative day 6. Adverse events and complications were recorded. MEASUREMENTS AND MAIN RESULTS: At rest, there were no differences in pain relief between the groups. Pain scores at mobilization showed a significantly lower value in the epidural group (p < 0.027). No intergroup differences were found regarding pulmonary function, which decreased on postoperative day 2, but was improved on postoperative day 6. CONCLUSION: Continuation of intraoperative thoracic epidural anesthesia for 5 postoperative days provides better pain relief at mobilization compared with a switch to patient-controlled analgesia with intravenous morphine. There was no intergroup difference in the impact on measures of pulmonary function.}}, author = {{Flisberg, Per and Törnebrandt, Kenneth and Walther, Bruno and Lundberg, Johan}}, issn = {{1532-8422}}, keywords = {{intravenous analgesia; thoracic epidural; esophagectomy; postoperative; morphine; bupivacaine}}, language = {{eng}}, number = {{3}}, pages = {{282--287}}, publisher = {{Elsevier}}, series = {{Journal of Cardiothoracic and Vascular Anesthesia}}, title = {{Pain relief after esophagectomy: Thoracic epidural analgesia is better than parenteral opioids}}, url = {{http://dx.doi.org/10.1053/jcan.2001.23270}}, doi = {{10.1053/jcan.2001.23270}}, volume = {{15}}, year = {{2001}}, }