A Comparison of Epidural 0.2% Ropivacaine Alone and in Combination with 4 microgram/ml Fentanyl for Postoperative Analgesia after Total Abdominal Hysterectomy / 대한마취과학회지

BACKGROUND: Epidural infusions usually comprise a local anesthetic, an opioid, or more commonly, a combination of the two, to minimize individual doses and to reduce unwanted side effects. The aim of this study was to compare analgesic and side effects of epidural infusion with 0.2% ropivacaine alone and in combination with 4 microgram/ml fentanyl after total abdominal hysterectomy. METHODS: Forty healthy total abdominal hysterectomy patients under general anesthesia with postoperative analgesia by continuous epidural infusion were randomly allocated into Group I; 0.2% ropivacaine alone (n = 20) or Group II; 0.2% ropivacaine and 4 microgram/ml fentanyl (n = 20). We assessed the visual analogue scale (VAS, 0 = no pain, 10 = worst pain), frequency of supplemental analgesics, side effects and patients' satisfaction of the result. RESULTS: The VAS and the frequency of supplemental analgesics were significantly lower and fewer in Group II compared to Group I. The incidence and severity of side effects were no differences between two groups. The satisfactions of patients were significantly higher in Group II. CONCLUSIONS: For postoperative analgesia, the epidural infusion of 0.2% ropivacaine with 4 microgram/ml fentanyl provided better analgesia than 0.2% ropivacaine alone.

A Comparison of Thoracic Versus Lumbar Epidural Meperidine for Analgesia after Thoracotomy / 대한마취과학회지

BACKGROUND: Meperidine, having intermediate lipid solubility, permits postthoracotomy analgesia. The aim of this study is to compare the analgesic efficacy, side effects, and patient satisfactions of istered thoracic versus lumbar epidural route anesthesia during the first 48 hours postthoracotomy. METHODS: A prospective randomized study was conducted for 48 hours after thoracotomy with ridine administered 50 mg as a bolus and continuously at 0.21 mg/kg/hr via either a thoracic (group T), or a lumbar (group L) epidural catheter at the end of the operation. Postoperative pain was assessed 2, 8, 24, 48 hours after the operation on a visual analog scale (VAS). Side effects and levels of patient ction of the epidural analgesia were assessed. RESULTS: There were no significant intergroup differences in heart rate, blood pressure, pain score, side effects and levels of patient satisfaction with analgesia. CONCLUSIONS: We conclude that there is no difference between thoracic and lumbar epidural eridine analgesia for postthoracotomy pain relief.