Korean J Pain.  2005 Dec;18(2):181-186. 10.3344/kjp.2005.18.2.181.

A Comparison of Hydromorphone-Bupivacaine and Fentanyl-Bupivacaine in Patient Controlled Epidural Analgesia after Thoracotomy

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea. drstone@netian.com

Abstract

BACKGROUND
Hydromorphone has an intermediate lipid solubility range that falls between morphine and fentanyl. Lipophilic activity during opioid epidural administration is important in relation to both the side effects and analgesic efficacy. The purpose of this study was to compare epidural hydromorphone and fentanyl when concomitantly infused with bupivacaine in patients undergoing a thoracotomy. METHODS: Seventy-seven thoracotomy patients, with patient-controlled epidural analgesia (PCEA), were blindly allocated into two groups [group F (n = 34); 0.1% bupivacaine and fentanyl 5microgram/ml, group H (n = 34); 0.1% bupivacaine and hydromorphone 16microgram/ml)]. The basal PCEA rate and demand dose were 4 ml/hr and 3 ml, respectively. The visual analogue scale (VAS) for pain, and pruritus, sedation and nausea were measured at 6, 12 and 24 hours after the operation. RESULTS: There were no significant differences in the VAS pain scores and the incidences of pruritus, nausea and sedation between the two groups. The total infused volume after 24 hours was lower in H compared to that of F group (P < 0.05). CONCLUSIONS: We conclude that epidural hydromorphone or fentanyl administration has a similar analgesic efficacy and shows similar incidences of side effects, when concomitantly infused with bupivacaine, in the management of acute pain following a thoracotomy.

Keyword

bupivacaine; epidural; fentanyl; hydromorphone; patient controlled analgesia

MeSH Terms

Acute Pain
Analgesia, Epidural*
Analgesia, Patient-Controlled
Bupivacaine
Fentanyl
Humans
Hydromorphone
Incidence
Morphine
Nausea
Pruritus
Solubility
Thoracotomy*
Bupivacaine
Fentanyl
Hydromorphone
Morphine
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