High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies
Background: Thoracic epidural analgesia offers effective perioperative pain relief in patients undergoing thoracotomies apart from attenuating stress responses. It helps in fast tracking by facilitating early mobilization and improving respiratory function. Literature on high (T1–T2 level) thoracic...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Annals of Cardiac Anaesthesia |
| Subjects: | |
| Online Access: | http://www.annals.in/article.asp?issn=0971-9784;year=2019;volume=22;issue=4;spage=383;epage=387;aulast=Sudheshna |
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| author | K Durga Sudheshna Ramachandran Gopinath Syama Sundar Ayya Prachi Kar Ravinuthala V Kumar |
| author_facet | K Durga Sudheshna Ramachandran Gopinath Syama Sundar Ayya Prachi Kar Ravinuthala V Kumar |
| author_sort | K Durga Sudheshna |
| collection | DOAJ |
| description | Background: Thoracic epidural analgesia offers effective perioperative pain relief in patients undergoing thoracotomies apart from attenuating stress responses. It helps in fast tracking by facilitating early mobilization and improving respiratory function. Literature on high (T1–T2 level) thoracic segmental analgesia for thoracotomy is less. Aim: The aim of present study was to compare the ease of insertion, effect on pain relief in high (T1–T2 level) vs mid (T5–T6) approach of thoracic epidural. Setting and Design: The present study was a randomized control trial conducted at our institute. Materials and Methods: About 52 patients aged between 18–65 years scheduled for elective thoracotomies under general and thoracic epidural anesthesia were randomized into two groups. Intraoperatively ease of epidural insertion, extent of blockade, and postoperatively pain relief were assessed. Ropivacaine with fentanyl was used for epidural analgesia. Statistical Analysis: Data were presented as mean ± standard deviation and analyzed by the Student's t test, Chi-square test, and non-parametric test whereever applicable. A P value <0.05 was considered statistically significant. Results: We observed that high thoracic epidural anesthesia was easier to place (time taken 123.42 vs 303.08 s) P < 0.05, with less number of attempts (1.27 vs 1.92) P < 0.05. Extent of blockade, postoperative pain scores, rescue analgesia requirement, hemodynamics, and oxygenation were comparable. Conclusion: We conclude that high thoracic epidural is easier to insert, provides adequate pain relief, and stable hemodynamics with the advantage of patient comfort and safety. |
| first_indexed | 2024-12-11T06:12:43Z |
| format | Article |
| id | doaj.art-b0c8a236dcca418098b9fce9a533c7e2 |
| institution | Directory Open Access Journal |
| issn | 0971-9784 |
| language | English |
| last_indexed | 2024-12-11T06:12:43Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Cardiac Anaesthesia |
| spelling | doaj.art-b0c8a236dcca418098b9fce9a533c7e22022-12-22T01:18:05ZengWolters Kluwer Medknow PublicationsAnnals of Cardiac Anaesthesia0971-97842019-01-0122438338710.4103/aca.ACA_169_18High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomiesK Durga SudheshnaRamachandran GopinathSyama Sundar AyyaPrachi KarRavinuthala V KumarBackground: Thoracic epidural analgesia offers effective perioperative pain relief in patients undergoing thoracotomies apart from attenuating stress responses. It helps in fast tracking by facilitating early mobilization and improving respiratory function. Literature on high (T1–T2 level) thoracic segmental analgesia for thoracotomy is less. Aim: The aim of present study was to compare the ease of insertion, effect on pain relief in high (T1–T2 level) vs mid (T5–T6) approach of thoracic epidural. Setting and Design: The present study was a randomized control trial conducted at our institute. Materials and Methods: About 52 patients aged between 18–65 years scheduled for elective thoracotomies under general and thoracic epidural anesthesia were randomized into two groups. Intraoperatively ease of epidural insertion, extent of blockade, and postoperatively pain relief were assessed. Ropivacaine with fentanyl was used for epidural analgesia. Statistical Analysis: Data were presented as mean ± standard deviation and analyzed by the Student's t test, Chi-square test, and non-parametric test whereever applicable. A P value <0.05 was considered statistically significant. Results: We observed that high thoracic epidural anesthesia was easier to place (time taken 123.42 vs 303.08 s) P < 0.05, with less number of attempts (1.27 vs 1.92) P < 0.05. Extent of blockade, postoperative pain scores, rescue analgesia requirement, hemodynamics, and oxygenation were comparable. Conclusion: We conclude that high thoracic epidural is easier to insert, provides adequate pain relief, and stable hemodynamics with the advantage of patient comfort and safety.http://www.annals.in/article.asp?issn=0971-9784;year=2019;volume=22;issue=4;spage=383;epage=387;aulast=SudheshnaEase of techniquehigh thoracic epiduralpain reliefropivacainethoracotomies |
| spellingShingle | K Durga Sudheshna Ramachandran Gopinath Syama Sundar Ayya Prachi Kar Ravinuthala V Kumar High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies Annals of Cardiac Anaesthesia Ease of technique high thoracic epidural pain relief ropivacaine thoracotomies |
| title | High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies |
| title_full | High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies |
| title_fullStr | High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies |
| title_full_unstemmed | High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies |
| title_short | High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies |
| title_sort | high vs mid thoracic epidural analgesia a comparative study on the ease of insertion and effects on pain hemodynamics and oxygenation in patients undergoing thoracotomies |
| topic | Ease of technique high thoracic epidural pain relief ropivacaine thoracotomies |
| url | http://www.annals.in/article.asp?issn=0971-9784;year=2019;volume=22;issue=4;spage=383;epage=387;aulast=Sudheshna |
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