Thoracotomy patients under general anesthesia: A comparison on intra-operative anesthetic and analgesic requirements, when combined with either epidural analgesia or continuous unilateral paravertebral analgesia

Abstract

Background and Objective: Regional analgesia is effective for post-thoracotomy pain. The primary objective of the study is to compare the intraoperative requirement of isoflurane and fentanyl between general anaesthesia (GA) with epidural analgesia and GA with paravertebral analgesia. Methods and Material: A prospective observational comparative study was conducted on 56 patients undergoing open thoracotomy procedures. The patients were divided into two groups of 28 by assigning the study participants alternatively to each group: Group GAE - received thoracic epidural catheterization with GA, and Group GAP - received ultrasound guided thoracic paravertebral catheterization on the operative side with GA. Intraoperative requirement of isoflurane, fentanyl, postoperative analgesia, stress response, need of rescue analgesics and adverse effects were observed and analysed. Results: 25 patients in each group were included in the data analysis. The intraoperative requirement of isoflurane (32.28 ± 1.88 vs 48.31 ± 4.34 ml; p 0.05). The incidence of adverse effects was comparable except for hypotension and urinary retention which were significantly higher in the GAE group. Conclusion: GA with epidural analgesia resulted in significant reduction in the intraoperative consumption of isoflurane and fentanyl in comparison to GA with paravertebral analgesia. However, both the techniques were equally effective in the postoperative period.

Keywords

• epidural and intraoperative fentanyl requirement
• epidural and intraoperative isoflurane requirement
• ga with epidural
• ga with unilateral paravertebral catheter
• paravertebral catheter and intraoperative fentanyl requirement
• paravertebral catheter and intraoperative isoflurane requirement
• thoracotomy pain unilateral paravertebral catheter