Thoracic epidural analgesia versus parenteral morphinefor post-thoracotomy pain relief

Aim The aim of this study was to evaluate the effects of thoracic epidural analgesia (TEA) with bupivacaine compared with postoperative intravenous morphine during thoracic surgery. Patients and methods A total of 40 patients were randomly divided into two groups with 20 patients in each group: group I (control group) comprised patients receiving general anesthesia and intravenous morphine for postoperative pain relief; group II (bupivacaine group) comprised patients receiving general anesthesia combined with 0.1 ml/kg of 0.25% bupivacaine plus 20 mg/ml fentanyl through an epidural catheter, followed by a 0.1 ml/kg/h infusion of bupivacaine for postoperative pain control.Results The present study proved that TEA provides optimal analgesia with better postoperative pulmonary function, oxygenation, and clearance of secretions secondary to pain control. In addition, TEA combined with general anesthesia is superior to general anesthesia and postoperative intravenous morphine as it reduces hormonal and metabolic stress responses, allows early extubation of our patients, decreases the length of stay in the intensive care unit, and decreases the incidence of postoperative side effects.