Journal of Clinical Monitoring and Computing

, Volume 22, Issue 4, pp 293–298 | Cite as

A Randomized-Controlled Study of Intrathecal Versus Epidural Thoracic Analgesia in Patients Undergoing Abdominal Cancer Surgery

  • Sebastiano Mercadante
  • Patrizia Villari
  • Alessandra Casuccio
  • Antonio Marrazzo



We sought to determine the effectiveness of continuous intrathecal thoracic analgesia (ITA) in comparison with continuous epidural thoracic analgesia (ETA) for the management of postoperative pain after abdominal cancer surgery in a randomised controlled study.

Materials and methods

Catheters were inserted at T8-10 level for both techniques. Sixty patients were randomized to receive ITA providing levobupivacaine 0.25%, at 0.5–0–7 ml/h, associated with a single bolus of morphine 0.15 mg, or ETA with levobupivacaine 0.25% 4–6 ml/h and a single bolus of epidural morphine 2–3 mg. Data were collected before discharging from recovery room to the surgical ward, 1, 2, 3, 8, 12, 24 h, and 48 h after operation. The primary outcome was pain intensity evaluation. Postoperative morphine consumption, hemodynamics, fluids, and blood losses for the first postoperative 48 h, surgical outcome, hospital stay, and complications were also collected.


Pain intensity at rest mean values ranged from 1.12 to 1.44 and from 1.04 to 1.20 in ITA group and ETA group, respectively. Dynamic pain intensity mean values ranged from 1.28 to 1.70 and from 1.16 to 1.80 in ITA group and ETA group, respectively. No significant differences were found between the two groups. Total amount morphine consumption was minimal in both groups, 4.4 mg (±2.9) and 3.1 mg (±2.4), for ITA and ETA groups, respectively. There were no severly sedated patients. Hemodynamic variables, diuresis, amounts of fluids, and red cell transfusion were equivalent between the groups. No important technical complications were reported in both groups and postoperative surgical complications were not related to the examined techniques.


ITA and ETA produced the same levels of analgesia, without relevant complications.


epidural analgesia intrathecal analgesia postoperative pain 


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Authors wish to thank the nurse staff of operatory room and surgical ward for their valuable support.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Sebastiano Mercadante
    • 1
  • Patrizia Villari
    • 1
  • Alessandra Casuccio
    • 2
  • Antonio Marrazzo
    • 3
  1. 1.Anesthesia & Intensive Care Unit, Pain Relief & Palliative Care UnitLa Maddalena Cancer CenterPalermoItaly
  2. 2.Department of NeuroscienceUniversity of PalermoPalermoItaly
  3. 3.Department of Oncologic SurgeryLa Maddalena Cancer CenterPalermoItaly

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