Korean J Anesthesiol Search

CLOSE


Korean J Anesthesiol > Volume 36(5); 1999 > Article
Korean Journal of Anesthesiology 1999;36(5):846-855.
DOI: https://doi.org/10.4097/kjae.1999.36.5.846   
A Comparison of Epidural Fentanyl-Bupivacaine and Intravenous Morphine Using Patient-Controlled Analgesia after Thoracic Surgery.
Dae Hyun Kim, Sang Hyun Kwak, Seong Hyun Yang, Seong Wook Jeong, Myung Ha Yoon, Chang Young Jeong
Department of Anesthesiology, Chonnam National University Medical School, Kwangju, Korea.
Abstract
BACKGROUND
Epidural and intravenous (IV) administration of opioids are commonly used for postoperative pain management. However, studies that compare the epidural and IV routes of opiate administration show conflicting results. The purpose of this study was to determine the superior route of analgesics by comparing the effect of epidural fentanyl-bupivacaine with IV morphine using patient-controlled analgesia (PCA) system in the management of posterior thoracic surgery pain.
METHODS
Sixty patients undergoing elective thoracic surgery were randomly assigned to receive either Epiural-PCA (Epi-PCA, n=30) or IV-PCA (n=30) when postoperative pain first increased to 40/100 mm (by visual analogue scale; VAS). Epi-PCA group received epidural bolus of 0.1% bupivacaine 10 ml containing fentanyl 100 microgram and then followed by Epi-PCA with 0.1% bupivacaine 100 ml containing fentanyl 800 microgram (basal infusion 2 ml/hr, PCA dose 1 ml, lock-out interval 30 min), IV-PCA group received repeated IV boluses of 3 mg of morphine until postoperative pain decreased to 40/100 mm and then followed by a IV-PCA with morphine (basal infusion 0.005 mg/kg/hr, PCA dose 0.02 mg/kg, lock-out interval 8 min). Analgesic efficacy, degree of patient satisfaction and pain, analgesics consumptions, forced vital capacity (FVC), forced expired volume in one second (FEV1) and side effects were evaluated.
RESULTS
There were no significant differences in analgesic efficacy and degree of patient satisfaction and pain in both group. But the PHS were significantly lower (p<.05), and FEV1 higher (p<.05) in Epi-PCA group, signifying better analgesia during movement (cough and deep breaths).
CONCLUSIONS
We concluded that an epidural PCA with mixture of fentanyl and bupivacaine administration is superior to that of intravenous PCA with morphine in the management of pain after thoracic surgery.
Key Words: Analgesia, epidural, intravenous, patient controlled; Analgesics, fentanyl, morphine; Surgery, thoracic
TOOLS
Share :
Facebook Twitter Linked In Line it
METRICS Graph View
  • 1 Crossref
  •    
  • 1,088 View
  • 5 Download


ABOUT
ARTICLE CATEGORY

Browse all articles >

BROWSE ARTICLES
AUTHOR INFORMATION
Editorial Office
101-3503, Lotte Castle President, 109 Mapo-daero, Mapo-gu, Seoul 04146, Korea
Tel: +82-2-792-5128    Fax: +82-2-792-4089    E-mail: journal@anesthesia.or.kr                

Copyright © 2023 by Korean Society of Anesthesiologists.

Developed in M2PI

Close layer
prev next