Comparison of Bupivacaine With Bupivacaine Plus Fentanyl Administered Via Thoracic Epidural Catheter for Pain After Thoracotomy in Children

Abstract

In this study, we aimed to compare the analgesic and side effects of bupivacaine versus bupivacaine and fentanyl combination administered via epidural cathater. Sixty children, aged 3-12 years, ASA I or II physical status, undergoing thoracic surgery were studied. All patients were monitorized routinely. Anaesthesia induced with sevoflurane or thiopenton, atracurium and fentanyl, and meintained with O2 + air, sevoflurane, atracurium and fentanyl. At the end of the operations, epidural catheters were placed below two dermatomes of the surgical incision. In the First Group, 0.3 mL kg-1 bupivacaine 0.125 % was administered as a bolus through the catheter, and infusion in a dose of 0.3 mL kg-1 h-1 added. In the Second Group, 2 mg mL-1 fentanyl and bupivacaine 0.125% was administered as a bolus in a dose of 0.3 mL kg-1 and infusion in a dose of 0.3 mL kg-1 h-1 added. Pain scores were decreased lower than four points in all patients except two patients in the first group, and three patients in the second group. In the second group, sedation scores were higher and pupil's diameters were smaller than the first group. In conclusion, thoracal epidural analgesia seems to be favorable method for pain relief after thoracotomy. However, we must be careful for sedation if opioids will be added to local anesthetics.