Effectiveness of pre-emptive thoracic epidural analgesia for acute post thoracotomy pain relief: a randomised blinded study

Anupananda Chowdhury, Dipika Choudhury, Upasana Majumdar, Trina Sen


Background: Thoracotomy is one of the most damaging surgical insults on respiratory mechanics and management of post-thoracotomy pain is a challenge. This study was conducted to compare intensity of postoperative pain, measured by VAS, in patients receiving Pre-emptive TEA compared to patients receiving epidural analgesia during surgical closure.

Method: Group A comprised of patients receiving Pre-emptive TEA with 0.1%Ropivacaine and 2 μg/ml fentanyl, 20 minutes before incision. Group B comprised of patients receiving the same drug, during surgical closure.

Results: Demographic profile was comparable between both groups. Both groups offered good analgesia, but pre-emptive group took an upper hand upto4th postoperative hour (p<0.05), both at rest and coughing. Beyond 4thhour, analgesic efficacy of both groups was comparable.

Conclusion: Pre-emptive technique offered better analgesia over the postoperative technique up to 4th postoperative hour, both at rest and coughing.


Pre-emptive, Ropivacaine, Thoracic epidural analgesia, Visual analogue scale

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