Comparison of continious extrapleural administration of bupivacaine versus ropivacaine on postthoracotomy pain and respiratory functions

COMPORISON OF CONTINIOUS EXTRAPLEURAL ADMINISTRATION OFBUPIVACAINE VERSUS ROPIVACAINE ON POSTTHORACOTOMY PAIN ANDRESPIRATORY FUNCTIONSSUNAY DEM RIn this study the post-operative pains of two groups of patients who receivedbupivacaine and ropivacaine through extraplevral catheter during thoracotomy surgeries werecompared; also, respiratory function test was carried out and the results were compared.30 patients in ASA II-III risk group who would undergo elective thoracotomy surgerywere included in the study. During the pre-operative period the Visual-Analogue Scala (VAS)scores of the patients, who did not receive premedication, were recorded and their FEV1,FVC, FEV1/FVC, FEF 25-75 results were determined by respiratory function test usingportable respiratory device. All the patients who were monitorized received general anesthesiaand at the end of the surgery the surgeons placed extrapleural catheter percutaneouslybetween parietal pleura and endothorasic fasia. After the repairment of pleura, an extrapleuralpouch which was suitable for continuous intercostal nerve blockade was created. The patientswere randomly divided into two groups and the first group of patients (n=15) wereadministered 0.5 % 20 ml bupivacaine while the second group (n=15) received the same doseand volume of ropivacaine. The haemodynamic parameters were recorded after theadministration of LA through catheter for two hours postoperatively. After extubation the firstgroup received 0.2 % 5 ml bupivacaine infusion per hour using PCA method whereas thesecond group received the same dose and volume of ropivacaine. At the postoperativeminutes of 30, 60, 90, 120 and the hours of 4, 8, 12, 24, 48 when the VAS score was found tobe higher than 4, 0.5 mg/kg im meperidin was administered and a record was kept; besides,the side effects were observed. Moreover, both of the groups who were expected to havechanges associated with pain went through RFT at the hours of 24 and 48. There were nosignificant differences between groups in respect to demographic characteristics, the time ofoperation and anesthesia, additional analgesic amount, side effects, and haemodynamicparameters.In the study it was determined that VAS scores were high in both of the groups at 30minutes and they were significantly high in ropivacaine group. VAS was low in the otherperiods in comparison with 30 minutes and no significant difference was observed betweenthe groups. There was a significant decrease in postoperative RFT parameters at 24 hour.Consequently, we consider for a continuous intercostal nerve blockade throughextrapleural catheter technique in post-thoracotomy patients the administration of 0.2 %bupivacaine and 0.2 % ropivacaine provides safe and similar analgesia during postoperativeperiod.