ABSTRACT
BACKGROUND: The study was performed to evaluate the effect of the thoracic epidural analgesia on the postoperative pain and pulmonary function after thoracoscopic surgery. METHODS: Postoperative pain control consisted of continuous thoracic epidural infusion of normal saline in group 1 (Control group) and 0.125% bupivacaine mixed with fentanyl 5microgram/ml in group 2 (TEA group) added in single intercostal nerve block patient in sixty patients who had undergone elective thoracoscopic surgery. The visual analogue scale (VAS), Prince-Henry score (PHS) and pulmonary function (FVC and FEV1) were measured preoperatively and postoperatively at 4, 8, 12, 24, 48 hours. RESULTS: There were significant improvement of the degree of pain in both groups but TEA group was lower than control group during 48 hours except at postoperative 4 hours. Pulmonary function was decreased less and recovered faster in TEA group than control group during 48 hours (P < 0.05). CONCLUSIONS: Thoracic epidural analgesia added in single intercostal nerve block has a benefit on the recovery of the postoperative pulmonary function and also provide superior analgesia after thoracoscopic surgery when compared to single intercostal nerve block alone. The authors recommend thoracic epidural analgesia for patient undergoing thoracoscopic surgery who receive single intercostal nerve block.