Mercadante, S., Villari, P., Casuccio, A., & Marrazzo, A. (2008). A randomized-controlled study of intrathecal versus epidural thoracic analgesia in patients undergoing abdominal cancer surgery. Journal of Clinical Monitoring and Computing, 22, 293–298.
To evaluate the effectiveness of intrathecal thoracic analgesia compared to continuous epidural analgesia for postoperative pain management
One group of patients received continuous epidural analgesia started prior to surgery, and the other group received an intrathecal catheter that was placed prior to surgery. Data for pain levels, vomiting, and drowsiness were obtained at discharge from the recovery room and at one, two, four, eight, 12, 24, and 48 hours. In both groups, the continuous infusion was of levobupivacaine, which was preceded by a morphine bolus preoperatively.
Randomized, parallel-group trial
There were no significant differences between groups in pain intensity or total morphine consumption. There also were no significant differences between groups in Bromage scores, sedation scores, or vital signs.
Continuous intrathecal analgesia provided similar analgesic effects as continuous epidural infusion in the first two postoperative days.
Intrathecal analgesic infusion provided results similar to those of continuous epidural analgesia in terms of postoperative pain relief and side effects of pain management. This approach provides an alternative mechanism for acute pain management.