A new technique for continuous intercostal-intrapleural analgesia in videothoracoscopic surgery.

Videothoracoscopic surgery has reduced the invasiveness of a considerable number of thoracic operations, although optimal postoperative thoracic analgesia remains an open issue. Among commonly used methods, continuous intravenous infusion of analgesics, including opioids and nonsteroidal anti-inflammatory drugs, has shown promise but is not always satisfactory and can have some adverse effects. We developed a new technique of continuous intercostal-intrapleural analgesia (CIIA) in videothoracoscopic lung resections, which is based on a double-catheter pain relief system (On-Q Pain Buster; I-Flow Corp, Lake Forest, Calif) to provide continuous infusion of ropivacaine (Figure 1, A).