Korean J Anesthesiol.  2000 Jul;39(1):83-90. 10.4097/kjae.2000.39.1.83.

The Comparison of Cryoanalgesia and Epidural Analgesia in Thoracotomy

• Choi IC
• Min HK
• Shim JY
• Kim JU
• Lee C
• Park SI

• KMID: 2091554
• DOI: http://doi.org/10.4097/kjae.2000.39.1.83

Abstract

BACKGROUND: Cryoanalgesia provides postoperative analgesia following thoracotomy without serious complications compared with epidural analgesia, but little data indicates which one is better in terms of postoperative analgesia, side effects or associated complications.
METHODS
Forty patients undergoing lateral thoracotomy, were randomized to receive a mixture of fentanyl and 0.15% bupivacaine at 0.5 microgram/kg/h of fentanyl via thoracic epidural catheter (Group E) or cryotherapy on the 4th, 5th, 6th, or 7th intercostal nerves using Frigitronics (Group C). Postoperative pain was assessed everyday for 7 days after the thoracotomy by a visual analog scale (VAS). The side effects and patient satisfaction of analgesia were assessed by a system of 4 grades.
RESULTS
The VAS scores at rest in group C were significantly higher than those in group E. There was no side effect except numbness in group C, which continued for 3 months on the average. The incidences of side effects (nausea, vomiting, pruritus, sedation, urinary retention) were 15-35% in group E. The 35% of patients in group C were satisfied with postoperative analgesia compared with 95% in group E (P < 0.05).
CONCLUSIONS
Epidural fentanyl provided a better analgesic effect than cryoanalgesia for thoracotomy, but there is a clinical advantage in cryoanalgesia over epidural fentanyl with respect to incidences of serious side effects not including. (Korean J Anesthesiol 2000; 39: 83-90)

Keyword

Analgesia: pain; postoperative; Anesthetic techniques: thoracic epidural; cryoanalgesia; Surgery: thoracotomy

MeSH Terms

Analgesia
Analgesia, Epidural*
Bupivacaine
Catheters
Cryotherapy
Fentanyl
Humans
Hypesthesia
Incidence
Intercostal Nerves
Pain, Postoperative
Patient Satisfaction
Pruritus
Thoracotomy*
Visual Analog Scale
Vomiting
Bupivacaine
Fentanyl