الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Many strategies to control postthoracotomy pain have been described, regional analgesia is the most logical approach .
This study was designed to compare the effectiveness of thoracic epidural fentanyl-bupivacaine versus intrapleural fentanyl-bupivacaine in postoperative pain relief following thoracotomy.
Thirty patients were included in this study(ASA1&11)of either sexes with age ranging from 20 to 50 years. The candidate patients were scheduled for elective thoracotomy for pulmonary resection.
The studied patients were divided into 2 groups:
GroupA: Thoracic epidural fentanyl-bupivacaine.(N=15)
GroupB:Intraplenral fentanyl-bupivacaine.(N=15)
Immediately in the postoperative period,epidural group received 10ml mixture of bupivacaine 0.25% and fentanyl 10 ug/ml, 5ml of this mixture was given every hour for 24 hours. Intrapleural group received 20 ml bupivacaine 0.5% and 100ug fentanyl immediately in the postoperative period, this dose was repeated every 4 hours for 24 hours .
The following parameters were assessed in both groups every 2hs in the first 12hs ,then every 6hs in the next 12 hs .
*Intensity of postoperative pain using Prince Henry pain scale.
*Arterial blood gases.
*Heart rate and mean arterial blood pressure.
*Postoperative respiratory rate, nausea, vomitting and itching.
Postoperative pain score was sigificantly lower at all time in epidural group than intrapleural group. Mean arterial blood pressure and heart rate were significantly lower in epidural group than intrapleural group. Nausea and vomitting occurred in one case of epidural group, also itching occurred in another case. There were no reported complications of intrapleural group.
It can be concluded that thoracic epidural fentanyl -bupivacaine is more effective in relieving postthoracotomy pain with more favourable hemodynamic effects than intrapleural fentanyl- bupivacaine.