Postoperative patient-controlled epidural analgesia by ropivacaine combined with small dose of sufentanil after thoracic surgery

Objective To compare the analgesia and side-effects of different concentration of rop- ivacaine combined with small dose of sufentanil for postoperative patient-controlled epidural analgesia after thoracic surgery.Methods Forty-five patients undergoing selective pulmonary lobectomy were randomly assigned to A,B,C groups.They received patient-controlled epidural analgesia with 0.3μg/ml sufentanil combined with ropivacaine 0.15%,0.175% or 0.2%(n=15).The PCEA pump was set up with back ground infusion of 5 ml/h,bolus dose 1 ml and lock-out period 15 min.VAS were used to assess analgesia at rest and movement.Vital capacity(VC)and maximum expiratory pressure(MEP)were recorded at dorsal decubitus.The total bolus doses,PCEA button pressing times(effevtive/actural),vital signs(MAP,HR, SpO_2,respiratory rates)and side-effects(nausea,vomiting,pruritus and dyspnea)were recorded postoper- atively at 4,8,16,24,48 hours.Results During the 48 hours after operation the VAS in group B and C were significantly lower than those in group A(P0.01),but the VC and MEP were higher than those in group A(P0.05),and there were no difference between B and C in statistics.The total amount of PCEA solution consumed and the actual PCEA button pressing times were significantly less in group B and C than those in group A(P0.05).The vital signs were stable and there were.no conspicuous differences of pruri- tus,nausea,vomiting and dyspnea.Conclusion 0.15%～0.2% ropivacaine combined with 0.3μg/ml snfentanil all can be used in PCEA after thoracic surgery,but the combination of 0.175% ropivacaine with sufentanil 0.3μg/ml provides optimal analgesia without increase in the consumption of ropivaealne and side- effects.