Analgesic Efficacy of Interpleurally Administered Morphine and Fentanyl After Posterolateral Thoracotomy

Pain control is a major concern in post-thoracotomy patients. the current prospective randomized double-blind study was designed to evaluate the analgesic effects of morphine and fentanyl given interpleurally after posterolateral thoracotomy. thirty patients undergoingelective posterolateral thoracotomy in a teaching hospital in tehran were divided into 3 groups with equal number of patients. patients in group ipm, ipf1 and ipf2 received 0.1 mg/kg morphine sulfate, 5 ug/kg fentanyl and 2.5 mog/kg fentanyl in a total volume of 40 ml injectedvia an intrapleural catheter placed in the pleural space before the closure of chest. subsequent doses of interpleural injections were administered at 4 and 8 h after operation. the intensity of pain was evaluated at rest and with coughing just before each interpleural injection and 30 min afterwards using a 10 point visual analogue scale (vas). if patients needed additional analgesia, indomethacin suppository and intravenous morphine were given during the 20-h postoperative study period. in all of the 3 study groups vas scores were significantly reduced 30 min after interpleural administration of the study solutions (p<0.05). however, inter-group comparisons revealed no significant differences for vsa scores, supplemental analgesic usageand systemic side effects. briefly, interpleural morphine and fentanyl following thoracotomy produce equal analgesia without major side effects.