Efficacy of continuous intercostal bupivacaine for pain relief after thoracotomy.
نویسندگان
چکیده
We studied 20 patients undergoing thoracotomy, in a double-blind, placebo-controlled crossover trial of intercostal bupivacaine. Bupivacaine 0.25% was infused at 5 ml h-1 through each of two catheters placed in the intercostal space at operation. Mean (95% confidence limits) 24-h requirements for morphine from a patient-controlled analgesia device were 29 (22-37) mg during bupivacaine infusion and 44 (32-57) mg during saline infusion (P = 0.04). Patients also recorded significantly smaller visual analogue scores for pain during bupivacaine infusion. There were no adverse effects related to the intercostal infusion of bupivacaine. We conclude that bupivacaine, infused through catheters placed during thoracotomy in the adjacent intercostal spaces, is a useful adjunct to systemic opioid analgesia.
منابع مشابه
Intercostal catheter analgesia is more efficient vs. intercostal nerve blockade for post-thoracotomy pain relief.
A pain after thoracotomy may result in a postoperative hypoventilation and lead to atelectases and pneumonia. This study was aimed to compare two analgesic regimens after posterolateral thoracotomy. 80 patients (40-70 years) undergoing thoracotomy were randomized to intercostal catheter analgesia (group A, n = 40) and intercostal nerve block (group B, n = 40). Patients in group A were given 20 ...
متن کاملبررسی تأثیر انفوزیون بوپیواکائین و نرمال سالین در کنترل درد پس از توراکوتومی؛ کارآزمایی بالینی
Background: Pain control after posterolateral thoracotomy is very important for adequate respiration and to reduce pulmonary complications. Narcotic-induced respiratory depression requires different intercostal nerve block procedures with local anesthesia, such as bupivacaine, through an extrapleural catheter, paravertebral catheter and intrapleural injection in order to control pain and reduce...
متن کاملComparative study of continuous extrapleural intercostal nerve block and lumbar epidural morphine in post-thoracotomy pain.
OBJECTIVES To compare the efficacy of continuous extrapleural intercostal nerve block with bupivacaine 0.5% in 1:200,000 epinephrine and continuous lumbar epidural block with morphine in controlling post-thoracotomy pain and to measure serum bupivacaine concentrations during extrapleural infusion. DESIGN A prospective, randomized, controlled trial. SETTING St. Joseph's Hospital, Hamilton, O...
متن کاملPost-thoracotomy pain and pulmonary function--comparison of intermittent intercostal bupivacaine vs intravenous pethidine.
OBJECTIVE AND METHODS In a prospective, observer-blind study, 50 patients scheduled for posterolateral thoracotomy were investigated to compare the effects of intermittent intercostal extrapleural bupivacaine (n = 25) and intravenous pethidine (n = 25) on post-thoracotomy pain and pulmonary function. The severity of chest pain (objectified by the use 5-point scale of Prince Henry) and changes i...
متن کاملTumour invasion of the brachial plexus: management of pain with intrapleural analgesia.
REFERENCES 1 Eng J, Sabanathan S. Site of action of continuous extrapleural intercostal nerve block. Ann Thorac Surg 1991; 51: 387-9. 2 Berrisford RG, Sabanathan S. Direct access to the paravertebral space at thoracotomy. Ann Thorac Surg 1990; 49: 854. 3 Mozell E J, Sabanathan S, Mearns A J, Bickford Smith PR, Majid MR, Zografos G. Continuous extrapleural intercostal nerve block after pleurecto...
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ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 70 5 شماره
صفحات -
تاریخ انتشار 1993