The effects of thoracal applications of bupivacaine and levobupivacaine on postoperative respiratory functions and pain

IVABSTRACTTHE EFFICIENCY OF THORACAL APPLICATIONS OF LEVOBUPIVACAINE ANDBUPIVACAINE ON POSTOPERATIVE RESPIRATORY FUNCTIONS AND PAINMANAGEMENTDr. Gokcen SerinResidency thesis; Department of Anesthesiology and ReanimationSupervisor : Assoc. Prof. Dr. Sıtkı GoksuMay 2007, 68 pagesWe compared the effects of levobupivacaine and bupivacaine on postoperativepain management and respiratory function tests after thoracotomies.30 patients in status ASA I-III, 18-80 years of age undergoing elective lungsurgery were randomly divided into two groups. Group I: General anesthesia+TEA(bupivacaine) Group II:General anesthesia+ TEA (levobupivacine)A thoracal epidural catheter was inserted into all patients preoperatively. Allpatients were dosed with a 0.1ml /kg/h bolus solution of 0.175 % bupivacaine/levobupivacaine and 15 µg /kg fentanyl via the epidural catheter and then thepatients were dosed with 0.1ml /kg/h of 0.125% bupivacine / levobupivacaine and 10µg /kg.The patients were applied 0.1ml/ kg /h of 0.1 %bupivacaine/ levobupivacine and5 µg /kg fentanyl as infusion postoperatively.Postoperative hemodynamic changes, pain scores, respiratory function tests andside effects were recorded.In both of the groups, VAS score at rest and coughing were low and it wasstatistically meaningful (p<0.05). There were no statistically differences between thegroups.In both of the groups, respiratory function tests were lower according to thepreoperative values.It was statistically meaningful (p<0.05) but these values weredecreased gradually for 48 hours.There were no statistically significant differencesbetween the groups. We think that TEA is too effective to get respiratory functiontests better gradually as a result of succesful postoperative pain management.We think that TEA decreases postoperative pain scores, permits the patients todo respiratory function tests better, to cough deeply and so decreases postoperativepulmoner complications.Key words:TEA, Levobupivacine, VAS, Respiratory function tests.