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• W2351330554 abstract "Objective To compare the influence of postoperative intercostal nerve freezing and epidural analgesia on blood coagulation in patients undergoing thoracic surgery. Methods Forty-six ASA I - III patients of both sexes (31 male, 15 female) aged 36-83 yr weighing 50-84 kg undergoing thoracic surgery (esophagus cancer resection and lung resection) under general anesthesia were randomly divided into group E - epidural analgesia (n = 24) and group C - intercostal nerve cryoanalgesia ( n = 22) . In group E, epidural catheter was placed at T7,8 . PCEA solution contained bupivacaine 30 mg + morphine 12.5 mg + droperidol 2.5 mg in 250 ml of normal saline. PCEA was commenced with a loading dose of 5-7 ml. The PCA pump was set up with a background infusion of 3 ml ·h-1, 3 ml bolus dose and a 30-minutes lockout interval. In group C, three intercostal nerves (the nerve in the thoracotomy incision and one nerve each above and below incision) were freezed ( - 70℃) for 90 seconds. Pain intensity was measured using NRS scores (0 ~ 10,0 = no pain, 10 = worst pain). Blood samples were taken before operation (T0) (baseline), at the end of operation (T1 ) , on the 1st, 3rd and 5th day after operation (T2 , T3 , T4) for thrombelastogrophy (TEG) analysis and determination of prothrombm time ( FT), activated partial thromboplastin time ( APTT) and plasma fibrinogen concentration ( FIB). Ultrasonography was used for detection of deep vein thrombus on the 7th-10 th day after operation. Results Analgesia was satisfactory in both groups. There was no significant difference in NRS scores between the tw o groups ( P 0.05). Hypercoagulation state was found in both groups as shown by shorter R-time and K-time, higher coagulation index ( CI) and plasma fibnnogen concentration and widerα-angle as compared to the baseline (T0) before operation. R-time was significantly shorter and CI and FIB concentration were significantly higher in group C than in group E at T2,4 . There was no significant difference in the incidence of deep vein thrombosis between the two groups( P 0.05) .Conclusion Intercostal nerve cryoanalgesia and epidural analgesia both provide satisfactory analgesia after thoracic surgery. Epidural analgesia can attenuate postoperative hypercoagulation state as compared with intercostals nerve cryoanalgesia." @default.
• W2351330554 created "2016-06-24" @default.
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• W2351330554 date "2005-01-01" @default.
• W2351330554 modified "2023-09-23" @default.
• W2351330554 title "Effect of postoperative intercostal cryoanalgesia and epidural analgesia on blood coagulation in patients undergoing thoracic surgery" @default.
• W2351330554 hasPublicationYear "2005" @default.
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