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Cited by 401Anesthesia and Pain ManagementPain Management and Opioid UsePain Management and Treatment

The Effects of Three Different Analgesia Techniques on Long-Term Postthoracotomy Pain

Şentürk, Mert, Özcan, Perihan Ergin, Talu, Gül Köknel, Kiyan, Esen, Çamci, Emre, Özyalçin, Süleyman, Dilege, Şükrü, Pembeci, Kamil·2002·Anesthesia & Analgesia
DOI 10.1213/00000539-200201000-00003
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Abstract

UNLABELLED: In this clinical, randomized, prospective study, we compared the effects of three different analgesia techniques (thoracic epidural analgesia [TEA] with and without preoperative initiation and IV patient-controlled analgesia [IV-PCA]) on postthoracotomy pain in 69 patients. In two groups, a thoracic epidural catheter was inserted preoperatively. Group Pre-TEA had bupivacaine and morphine solution preoperatively and intraoperatively. Postoperative analgesia was maintained with epidural PCA with a similar solution. Group Post-TEA, with no intraoperative medication, had the same postoperative analgesia as Group Pre-TEA plus the bolus dose. Group IV-PCA received only IV-PCA with morphine for postoperative analgesia. Pain was evaluated every 4 h during the first 48 h at rest, cough, and movement. Pre-TEA was associated with decreased pain compared with the other groups. Six months later, the patients were asked about their pain. The incidence and the intensity of pain were most frequent in Group IV-PCA (78%) and were the least in Group Pre-TEA (45%) (Group Pre-TEA versus Group IV-PCA, P = 0.0233; Group Pre-TEA versus Group IV-PCA, P = 0.014). Patients having pain on the second postoperative day had 83% chronic pain. TEA with preoperative initiation is a preferable method in preventing acute and long-term thoracotomy pain. IMPLICATIONS: Preoperatively initiated thoracic epidural analgesia has the most satisfying results in controlling postthoracotomy pain in the acute and long-term period, and it is associated with a decreased incidence (and intensity) of chronic pain compared with postoperative (epidural or IV) analgesia. Chronic pain has an incidence of 62%.

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  • In one study, thoracic epidural analgesia initiated preoperatively significantly reduced CPSP at 6 months postoperatively compared with intravenous patient-controlled analgesia with morphine started postoperatively.

    “One study compared three analgesic techniques: thoracic epidural analgesia initiated preoperatively and intraoperatively (with patient-controlled epidural analgesia provided postoperatively in both instances); and intravenous patient-controlled analgesia with morphine, started postoperatively. It was found that CPSP was significantly reduced 6 months postoperatively by using the thoracic epidural”

    From Chronic postsurgical pain: current evidence for prevention and management (2018) · cites this paper as [30]

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Authors
Şentürk, M., Özcan, P. E., Talu, G. K., Kiyan, E., Çamci, E., Özyalçin, S., Dilege, Ş., & Pembeci, K.
Corresponding author
  • Özcan, Perihan Ergin
  • Talu, Gül Köknel
  • Pembeci, Kamil
ORCID
Venue
Anesthesia & Analgesia
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-01
Volume
94
Issue
1
Pages
11-15
ISSN
0003-2999 (ISSN-L)
DOI
10.1213/00000539-200201000-00003
OpenAlex
W2012716406
Cited by
401
References
10
Citations by year
2026: 2 · 2025: 6 · 2024: 11 · 2023: 10 · 2022: 7 · 2021: 16 · 2020: 12 · 2019: 18 · 2018: 20 · 2017: 19 · 2016: 15 · 2015: 22 · 2014: 21 · 2013: 25 · 2012: 18
FWCI
13.33
Type
journal article
Language
en
Open access
closed
Locations
  • Anesthesia & Analgesia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
post-thoracotomy pain, thoracic epidural analgesia, patient-controlled analgesia, intravenous analgesia, chronic postoperative pain, bupivacaine, morphine, thoracotomy
MeSH terms
Analgesics, Opioid, Anesthetics, Local, Bupivacaine, Female, Humans, Male, Middle Aged, Morphine, Pain Measurement, Postoperative Pain, Preoperative Care, Prospective Studies, Thoracic Vertebrae, Thoracotomy, Analgesia, Epidural, Analgesia, Patient-Controlled

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