ABSTRACT
Background: Postoperative discomfort has a negative impact on the outcome of thoracic surgical procedures, which are among the most painful operations. Controlling pain after a thoracotomy enhances patient satisfaction while lowering postoperative morbidity. Aim of the study: The aim of the study was to evaluate the effects of thoracic epidural and conventional pain management methods in post-thoracotomy patients.Material & Methods:A randomized cross-sectional comparative study was conducted among 260 patients of post thoracotomy between January 2018 and December 2020 in a single tertiary-care hospital of Dhaka, Bangladesh. Outcomes of surgery were evaluated using the visual analogue score (VAS) at resting and coughing time.Results:We divided all 260 patients into two groups (group A: thoracic epidural 130; group B: conventional/control 130). The mean age of the patients was 49.74�.46 years in group A and 50.48�.23 in group B. There were 61% male patients and 39% female patients, and the male: female ratio was 81:48 in group A, and 78:53 in group B. Mean duration of surgeries was 2.95� 67.92 hours and 2.84� 57.31 hours in group A and B respectively and mean follow up was 1.9 years and 1.4 years in group A and B respectively. The maximum number (36.9%%) of patients were in the age group of 50 to 54 years, and the minimum number (4.61%) of patients were in the age group of 35 to 39 years. In group A, the maximum number (31) of patients had gone through open window formation, and a minimum number of patients (4) had gone through segmentectomy. And in group B, the maximum number (33) of patients had gone through open window formation, and a minimum number (4) had gone through hydatid cyst removal surgery. The change between comparative values of postoperative mean VAS scores at resting time and coughing time of both groups of patients was significant in this study.Conclusions:In thoracotomy surgery, the efficacy of thoracic epidural anesthesia is more evident than in other types of surgery. Although managing thoracotomy pain might be challenging, the advantages of proper pain management are substantial.