Comparison of efficacy and safety profiles of epidural analgesia and opioid analgesia in Chinese patients with thoracic trauma: A preliminary report

Abstract

Purpose: To compare the efficacy and safety profiles of epidural analgesia (EA) and opioid analgesia (OA) in Chinese patients with thoracic trauma (TT). Methods: Patients with confirmed diagnosis of thoracic trauma were given either EA (via a catheter) or slow-release OA. The following efficacy variables were assessed in the two treatment groups: pain score, and changes in cytokine and catecholamine levels from baseline after treatment. Moreover, respiratory parameters were determined before and after treatment. The safety associated with each anesthesia was also evaluated. Quantitative data were analyzed either with Student’s t-test or MannWhitney test, while  categorical data were analyzed using Fisher exact or Chi-square test, based on data size. Results: A total of 200 patients completed the study (100 patients in each group). Pain, as assessed by verbal rating scale (VRS), was slightly lower in patients after treatment with EA, when compared to the patients treated with OA. However, the difference was not statistically significant (p < 0.05). Maximum inspiratory force (cmH2O) and tidal volume (liters) were slightly improved in patients  treated with EA, when compared to OA-treated patients, although the difference was not statistically significant (p < 0.05). Moreover,  the two treatments produced comparable levels of cytokines and catecholamines. Conclusion: The efficacy and safety data for EA and OA in Chinese non-obese patients with TT indicate numerically favorable outcome for EA, when compared to OA. Keywords: Epidural analgesia, Opioid analgesia, Chinese patients, Thoracic trauma