POST OP PAIN RELIEF BY THORACIC EPIDURAL VS SYSTEMIC OPOID BASED MANAGEMENT IN THORACIC SURGERIES- A COMPARATIVE STUDY

Abstract

Objectives: The main objective of the study is to compare post op pain relief by thoracic epidural vs systemic opoid based management in thoracic surgeries- a comparative study

Study design and place of study: Comparative Cross-Sectional study, September 2024- February 2025, Territiary care hospital, Lahore

Methodology: 80 patients were included in this study. Patients were randomly allocated into two groups (n=40 each): Group E received thoracic epidural analgesia, while Group O received systemic opioid-based analgesia. Pain was assessed using the Numerical Rating Scale at rest and on coughing at 2, 6, 12, 24, and 48 hours. Respiratory parameters, hemodynamics, complications, and hospital stay were recorded. Data were analyzed using SPSS, with p<0.05 considered statistically significant.

Results:  Eighty patients were equally divided into Group E and Group O, with comparable baseline characteristics (p>0.05). Postoperative pain scores were significantly lower in Group E at all time points. At 2 hours, NRS at rest was 2.8 ± 0.9 in Group E versus 5.6 ± 1.1 in Group O (p<0.001), with similar trends up to 48 hours. Pain during coughing was also significantly lower in the epidural group (p<0.001). Respiratory parameters were better in Group E, with higher SpO₂ (97.8 ± 1.2% vs 95.9 ± 1.5%), improved spirometry (1650 ± 250 ml vs 1200 ± 220 ml), and lower respiratory rate (p<0.001). Hospital stay was shorter in Group E (5.2 ± 1.1 vs 7.1 ± 1.5 days, p<0.001).

 Conclusion: Thoracic epidural analgesia as the preferred modality for postoperative pain management in thoracic surgeries.