Intra-operative XXXX for postoperative analgesia in thoracotomy @entity1 : a randomized, double-blind, placebo-controlled study.

@entity1 @entity390 @entity391 @entity1342 @entity111 @entity158 @entity1286 @entity1443 @entity282 @entity616
OBJECTIVE: Epidural analgesia is the gold standard for post-thoracotomy @entity158 relief but is contraindicated in certain @entity1 . An alternative is @entity616 . We investigated whether @entity1342 , administered through a paravertebral catheter placed by the surgeon, reduced @entity282 . METHODS: In a randomized double-blind study, adult @entity1 with a paravertebral catheter placed by the thoracic surgeon after thoracotomy were randomly assigned to receive through this catheter, either a 0.1 mlkg(-1) bolus of 0.5% @entity1342 , followed by a continuous infusion of 0.1 mlkg(-1)h(-1) for 48 h, or saline at the same scheme of administration. @entity1 also benefited from @entity1 -controlled analgesia with intravenous @entity1286 (bolus 1mg, lockout time 7 min), @entity1443 , and nefopam. The primary endpoint was @entity158 intensity on a visual analog scale at rest and on coughing. Secondary endpoints were total @entity1286 consumption and side effects during the first 48 postoperative hours. Surgeons, anesthesiologists, and all the nurses and caring staff involved in this study were blinded. Solutions of saline and @entity1342 were prepared identically by the central pharmacy, without any possible identification of the product. RESULTS: Forty-seven @entity1 with contraindications to epidural anesthesia were included. There were no significant differences between the groups receiving @entity1342 and saline in terms of @entity158 severity at rest and on coughing, mean postoperative @entity1286 consumption (45.7 mg for @entity1342 , 43.2mg in controls), and incidence of @entity1286 -related side effects ( @entity390 and @entity391 , urinary retention, @entity111 , respiratory rate, and sedation). CONCLUSIONS: Paravertebral block using a catheter placed by the thoracic surgeon was ineffective on @entity282 after thoracotomy and did not confirm the analgesic effect that has been observed after percutaneous catheter placement. A direct comparison of these two placement methods is required.
