Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 micrograms ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Noncompartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of distribution at steady state or elimination half-life of bupivacaine. However, ...

Interpleural blockade is effective in treating unilateral surgical and nonsurgical pain from the chest and upper abdomen in both the acute and chronic settings. It has been shown to provide safe, high-quality analgesia after cholecystectomy, thoracotomy, renal and breast surgery, and for certain invasive radiological procedures of the renal and hepatobiliary systems. It has also been used succe...

Until recently, the clinical significance of post-surgical pain and its undertreatment were for the most part unappreciated. Recognition that inadequate analgesia adversely affects the patient's cardiovascular, pulmonary, and emotional status has spurred development of new and highly effective methods of controlling pain. With the introduction of spinal opioid and patient-controlled analgesia (...

OBJECTIVES To describe the microbiological characteristics of a cohort of patients with complicated parapneumonic effusion and empyema thoracis, and to identify the potential risk factors for adverse outcomes, with particular reference to the choice of empirical antibiotics, intrapleural fibrinolytics, adherence to management guidelines, and input from pulmonologists. DESIGN Retrospective rev...

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...