Comparison of analgesic and hemodynamic effects of intramuscular meperidine, epidural bupivacaine, morphine-bupivacaine and clonidine-bupivacaine after thoracotomy Torakotomi sonrasi uygulanan intramüsküler meperidin, epidural bupivakain, morfin-bupivakain ve klonidin-bupivakainin analjezik ve hemodinamik etkilerinin karşilaştirilmasi
Anestezi Dergisi, vol.11, no.3, pp.189-194, 2003 (Scopus, TRDizin)
- Publication Type: Article / Article
- Volume: 11 Issue: 3
- Publication Date: 2003
- Journal Name: Anestezi Dergisi
- Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
- Page Numbers: pp.189-194
- Keywords: Bupivacaine, Clonidine, Epidural analgesia, Morphine, Pain relief, Thoracotomy
- Ankara University Affiliated: Yes
Abstract
In this study we compared analgesic and hemodynamic effects of intramuscular meperidine, epidural bupivacaine, morphine-bupivacaine and clonidine-bupivacaine administered after thoracotomy. The patients were divided into four groups which consisted of ten patients. In the postoperative 30th minute, Group I was given 75 mg im meperidine; Groups II, III, IV received 30 mg bupivacaine, 2 mg morphine plus 25 mg bupivacaine, 150 mg clonidine plus 25 mg bupivacaine via thoracic epidural catheters respectively. When VAS ≥ 4, VAS during coughing ≥ 7 and VS ≥ 2, additional analgesic was given. Additional analgesic was 25 mg im meperidine in Group I and 15 mg bupivacaine epidurally in the other groups. Systolic, diastolic and mean arterial pressures (SAP, DAP, MAP) and heart rate (HR) were recorded preoperatively. In the postoperative 30th min, 1st, 2nd, 4th, 8th, 12th, 24th hours VAS, VAS during coughing, VS, SAP, DAP, MAP and HR were noted. Side effects were recorded. In Groups III and IV, VAS, VAS during coughing and VS scores declined significantly in the postoperative 8th, 12th and 1st hour, respectively (p<0.05). In Group IV, MAP value was significantly lower than the other groups in the postoperative 1st hour (p<0.05). We concluded that the morphine-bupivacaine combination given via epidural catheter, provided longer analgesia and stable hemodynamics and therefore was found to be superior for post-thoracotomy pain management.