Bupivakain ve levobupivakain'in torakal epidural uygulamalarinda postoperatif solunum fonksiyonlari ve aǧri üzerine etkileri

We aimed to compare the effects of levobupivacaine and bupivacaine on postoperative pain management with thoracal epidural analgesia (TEA) and respiratory function tests after thoracotomies. 30 patients in status ASA I-III, 18-80 years of age undergoing elective lung surgery were randomly divided into two groups. Group I: General anesthesia+TEA (bupivacaine with fentanyl) and Group II: General anesthesia+ TEA (levobupivacine with fentanyl). A thoracal epidural catheter was inserted into all patients preoperatively. Equal concentration and volume bupivacaine plus fentanyl or levobupivacaine plus fentanyl were administered as bolus. The maintenance was given as infusion. Postoperative hemodynamic changes, pain scores, respiratory function tests and side effects were recorded. In both of the groups, VAS score at rest and coughing were low and statistically significant (p<0.05). There were no statistically differences between the groups as for VAS scores. In both of the groups, respiratory function tests were lower relative to the preoperative values. The difference was statistically significant (p<0.05) but these values were decreased gradually over 48 hours. There were no statistically significant differences between the groups with respect to. We think that TEA decreases postoperative pain scores, permits the patients to do respiratory function tests better, to cough deeply and so decreases postoperative pulmonary complications. In the present study, TEA with fentanyl added either to levobupivacaine or bupivacaine reduced post-thoracotomy pain and improved respiratory functions similarly.