ORIGINAL ARTICLE
Year : 2012  |  Volume : 5  |  Issue : 3  |  Page : 307-312

Dexamethasone as an adjuvant to thoracic epidural provided more prolonged analgesia for post-thoracotomy pain than clonidine and fentanyl


Department of Anesthesia, Faculty of Medicine, Benha University, Benha City, Egypt

Correspondence Address:
Mohamed Ahmed Al-Rabiey
MD, Department of Anesthesiology, Faculty of Medicine, Benha University, 13111 Benha City
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.ASJA.0000417545.59332.39

Rights and Permissions

Objectives

To evaluate the analgesic yield of thoracic epidural (TE) analgesia using bupivacaine in combination with dexamethasone, clonidine versus fentanyl for thoracotomy patients.

Patients and methods

Sixty patients were divided into four equal groups, which received TE analgesia immediately at end of surgery during skin closure using bupivacaine either alone (C group) or in combination with dexamethasone (S1 group), clonidine (S2 group), or fentanyl (S3 group). Postoperative (PO) pain was measured using a visual analogue scale (VAS); rescue analgesia (50 mg mepridine) was given when a patient had a VAS score of 40, and the duration of analgesia and the total mepridine doses consumed were determined during 24-h postoperatively. Verbal rating scores were used for the evaluation of PO sedation and nausea and vomiting (PONV).

Results

The mean duration of analgesia was significantly longer in the study groups compared with group C, with a significantly longer duration in the S1 group compared with the S3 group. The mean 24-h cumulative pain VAS score and the total PO rescue analgesia consumed were significantly lower in the S1 group compared with the other groups and in the S2 group compared with group C. Both S2 and S3 groups showed significantly higher frequency of higher sedation scores compared with the C and S1 groups. The frequency of patients who had a PONV zero score was significantly higher in the S1 group compared with the other groups, with a nonsignificant difference among the other groups.

Conclusion

TE analgesia using bupivacaine with clonidine or dexamethasone is an efficient therapeutic modality for post-thoracotomy pain. Dexamethasone as an adjuvant provided more prolonged PO analgesia, with a reduction of rescue analgesia consumption without PO sedation, and spares the use of antiemetics for PONV that was minimized in frequency and severity.



[PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1138    
    Printed33    
    Emailed0    
    PDF Downloaded178    
    Comments [Add]    

Recommend this journal