The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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A Comparison of Hydromorphone-Bupivacaine and Fentanyl-Bupivacaine in Patient Controlled Epidural Analgesia after Thoracotomy

개흉술 후 경막외 통증자가조절을 설시한 환자에서 Hydromorphone-Bupivacaine과 Fentanyl-Bupivacaine 투여의 비교

  • Sim, Woo Seok (Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine) ;
  • Yeo, Jin Seok (Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine)
  • 심우석 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 여진석 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실)
  • Received : 2005.09.20
  • Accepted : 2005.12.09
  • Published : 2005.12.10
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Abstract

Background: Hydromorphone has an intermediate lipid solubility range that falls between morphine and fentanyl. Lipophilic activity during opioid epidural administration is important in relation to both the side effects and analgesic efficacy. The purpose of this study was to compare epidural hydromorphone and fentanyl when concomitantly infused with bupivacaine in patients undergoing a thoracotomy. Methods: Seventy-seven thoracotomy patients, with patient-controlled epidural analgesia (PCEA), were blindly allocated into two groups [group F (n = 34); 0.1% bupivacaine and fentanyl $5{\mu}g/ml$, group H (n = 34); 0.1% bupivacaine and hydromorphone $16{\mu}g/ml$)]. The basal PCEA rate and demand dose were 4 ml/hr and 3 ml, respectively. The visual analogue scale (VAS) for pain, and pruritus, sedation and nausea were measured at 6, 12 and 24 hours after the operation. Results: There were no significant differences in the VAS pain scores and the incidences of pruritus, nausea and sedation between the two groups. The total infused volume after 24 hours was lower in H compared to that of F group (P < 0.05). Conclusions: We conclude that epidural hydromorphone or fentanyl administration has a similar analgesic efficacy and shows similar incidences of side effects, when concomitantly infused with bupivacaine, in the management of acute pain following a thoracotomy.

Keywords

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