Gordana Taleska, Trajanka Trajkovska, Anita Kokareva, Anita Popovska, Maja Naumoska, Aleksandra Gavrilovska, Vanja Dzhambazovska-Trajkovska, Marija Toleska, Aleksandar Dimov

Aim. The aim of the study was to determine if preemptive epidural analgesia in thoracic surgery reduces postoperative pain, and to compare these effects in relation to the usage of epinephrine.

Material and Methods. Sixty patients admitted for thoracic surgery were randomly allocated into three groups (n = 20 each). Group A received bupivacaine and sufentanyl epiduraly prior to skin incision, followed by infusion of bupivacaine and sufentanyl. Group B (control) received saline in the epidural. In both groups patients received bupivacaine and sufentanyl epiduraly at the time of the chest closure. In Group C the same doses of bupivacaine and sufentanyl as in Group A were given to the patients including epinephrine in the epidural mixture. The level of statistical significance was pointed at p < 0.05.

Results. The patients in Group A had lower intraoperative isofluran requirements, lower postoperative epidural infusion rates and lower pain scores in first eight postoperative hours, compared with the control. In the epinephrine group patients had lower pain intensity and smaller needs for postoperative epidural infusion rate than those in Group A.

Conclusion. The usage of epinephrine has caused less nausea and easier mobilization. While there was a beneficial effect of the reduced intraoperative anesthetic requirements, any lasting effect of preemptive analgesia did not extend beyond eight hours after the operation.