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Peri-operative thoracic epidural analgesia for thoracotomy

Published online by Cambridge University Press:  16 August 2006

A.-M. Schultz
Affiliation:
Department of Anaesthesiology and General Intensive Care, University of Vienna, Allgemeines Krankenhaus, Währinger Gürtel 18-20, A-1090 Vienna
A. Werba
Affiliation:
Department of Anaesthesiology and General Intensive Care, University of Vienna, Allgemeines Krankenhaus, Währinger Gürtel 18-20, A-1090 Vienna
S. Ulbing
Affiliation:
Department of Anaesthesiology, Krankenhaus des Deutschen Ordens, St. Veiter Straße 12, A-9360 Friesach, Austria
G. Gollmann
Affiliation:
Department of Anaesthesiology, Krankenhaus des Deutschen Ordens, St. Veiter Straße 12, A-9360 Friesach, Austria
F. Lehofer
Affiliation:
Department of Anaesthesiology, Krankenhaus des Deutschen Ordens, St. Veiter Straße 12, A-9360 Friesach, Austria
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Abstract

In a prospective study, experiences with peri-operative thoracic epidural analgesia (TEA) for thoracic surgery were documented. Two hundred and seven patients scheduled for elective thoracotomy were investigated. All patients received thoracic epidural catheters 2 h pre-operatively. The catheters were inserted between T4–5 and T8–9 intervertebral spaces. Epidural medication with bupivacaine and fentanyl was started pre-operatively, maintained throughout surgery and was continued post-operatively via patient controlled analgesia (PCA) devices. Patients were anaesthetized with propofol and tracheal intubation was performed following neuromuscular blockade with vecuronium. Ninety-five percent of the patients were extubated immediately after surgery. 70.5% of all the patients had excellent post-operative analgesia (VAS pain scoring 0–2) on the day of surgery, 78% the day after surgery and 91% on the second day after surgery. Additionally early post-operative mobilization could be started in 63% of all patients. No neurological sequelae caused by thoracic epidural catheterization was seen in the early post-operative period.

Type
Original Article
Copyright
1997 European Society of Anaesthesiology

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