Objective: To assess the effectiveness of the long acting local anesthetic (0.25% ropivacaine) intermittently administered through an extrapleural paravertebra/ catheter versus a thoracic epidural catheter on postthora- cotomy pain relief. Patients and Methods: Forty patients undergoing elective posterolateral thoracotomy during the period between July 2001 and August 2002 were prospectively studied. They were randomly allocated into two groups (A and B) of 20 patients each. Group A patients received an epidural-type catheter .inserted by the surgeon into an extTapleural pocket extending for 2 to 3 intercostal spaces both above and below the thoracotomy incision alongside the vertebral column by the conclusion of operation. A bolus dose of 15 ml of 0.25% ropivacaine analgesia was given during chest closure.Group1B patients received a thoracic epidural catheter inserted by the anesthesiologist at T5-6 or T6-7 interspace before induction of anesthesia. A bolus dose of 15 ml of 0.25% ropivacaine analgesia was given after confirming the correct position of the epidural catheter. Postoperatively. patients in both groups were intermittently administered 25 ml of 0.25% ropivacaine analgesia at 6 hourly intervals for 3 successive days. Pain scores (verbal rating scale), requirement of arida -tonal analgesia (NSA1D), pulmonary fwiction test, shoulder range of motion as well as any complication encountered were assessed and compared in both groups |
