PATIENT CONTROLLED EPIDURAL ANALGESIA WITH BUPIVACAINE AND SUFENTANIL FOLLOWING THORACOLUMI3AR SCOLIOSIS CORRECTION. COMPARATIVE STUDY BETWEEN LUMBAR AND THORACIC SITES
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To compare the efficacy of patient-controlled lumbar and thoracic epidural sufentanil and bupivacairte, 20 patients scheduled for elective correction of thoracolumbar scoliosis were assigned randomly to receive sufentanil and bvivacaine via either a lumbar or thoracic epidural catheter, placed by the surgeon upon completion of fixation and before closure of the wound. There were significant better pain relief in thoracic group manifested by the changes in VAS for pain at rest (VAS-R) and at function (VAS-F).T'he pulmonary functions tests (VC, FVC, FEV1/FVC 96) were significantly less decreased in the thoracic epidural group. The analgesic efficacy of thoracic epidural infusion leads to minimal need for top up bolus doses. There were no serious side effects in this study. The study concluded that thoracic epidural infusion of sufentanil and bupivacaine by PCA rtinchine seems to be an optimal strategy for postoperative pain relieffollowing correction of thoracolurnbar scoliosis.