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Korean Journal of Anesthesiology 2004;47(4):532-536.
DOI: https://doi.org/10.4097/kjae.2004.47.4.532   
An Optimal Regimen of 0.2% Ropivacaine-Sufentanil as a Continuous Thoracic Epidural Infusion for Pain Control after Thoracotomy.
Mi Kyeong Kim, Young Lan Kwak, Jong Hwa Lee, Byung In Choi, Duck Mi Yoon
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. dmyoon@yumc.yonsei.ac.ke
2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Thoracotomy is considered one of the most painful surgical procedures. Thus optimal pain control is essential in the postoperative care of thoracotomy patients. In this randomized double-blinded study, we sought to determine an optimal dose-combination of sufentanil and ropivacaine 0.2% for postoperative epidural analgesia.
Forty-five of fifty-two patients that underwent thoracotomy were assigned to three groups to receive continuous high thoracic epidural analgesia with ropivacaine 0.2% + sufentanil 0.5microgram/ml (group I), ropivacaine 0.2% + sufentanil 0.75microgram/ml (group II), or ropivacaine 0.2% + sufentanil 1.0microgram/ml (group III). Upon completion of surgery, a thoracic epidural catheter was inserted at the T1-3 level, and moved downward by 5-7 cm. Epidural continuous infusion was administered at 5 ml/hr. Resting VAS (visual analogue scale), dynamic VAS, forced vital capacity, and side effects were recorded at three times: immediate after extubation; 12 hours after arrival at the ICU; and 24 hours after arrival at the ICU.
Resting VAS was significantly lower in group III immediately after extubation (P < 0.05) and dynamic VAS was significantly lower in group III immediately after extubation, and 12 hours after arriving at the ICU (P < 0.05) than in the other two groups. The differences in ketorolac dosing number, sedation scores, respiratory depression, pruritus, nausea/vomiting, and motor block were not significant between the three groups.
We conclude that the combination of ropivacaine 0.2% and sufentanil 1.0microgram/ml provides effective analgesia for post-thoracotomy pain with fewer side effects than the other two combinations tested.
Key Words: epidural analgesia; sufentanil; ropivacaine; thoracotomy


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