ANALGESIC AND PULMONARY EFFECTS OF CONTINUOUS INTERCOSTAL NERVE BLOCK FOLLOWING THORACOTOMY

被引:40
作者
CHAN, VWS [1 ]
CHUNG, F [1 ]
CHENG, DCH [1 ]
SEYONE, C [1 ]
CHUNG, A [1 ]
KIRBY, TJ [1 ]
机构
[1] UNIV TORONTO, TORONTO HOSP, DEPT SURG, TORONTO M5T 2S8, ONTARIO, CANADA
来源
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE | 1991年 / 38卷 / 06期
关键词
ANESTHETICS; LOCAL; BUPIVACAINE; ANESTHETIC TECHNIQUES; REGIONAL; INTERCOSTAL; PAIN; POSTOPERATIVE;
D O I
10.1007/BF03008451
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
This study examines the beneficial effects and potential systemic toxicity from continuous intercostal nerve block by repeated bolus injections of bupivacaine. In this double-blind, randomized study, 20 post-thoracotomy patients were assigned to receive four doses of either: 20 ml 0.5% bupivacaine with epinephrine 5-mu-g.ml-1 (bupivacaine group, n = 10), or 20 ml preservative-free saline (placebo group, n = 10) through two indwelling intercostal catheters every six hours. Patients receiving intercostal bupivaccaine injections had greater decreases in visual analogue pain scores (VAS) (P < 0.05) and lower 24 hr morphine requirements, 16.6 +/- 4.6 mg vs 35.8 +/- 7.2 mg, than patients in the placebo group (P < 0.05). Higher post-injection values of forced expiratory volume in one second, forced vital capacity and peaked expiratory flow rate were also observed in the bupivacaine group (P < 0.01). Repeated intercostal bupivacaine administration did lead to systemic accumulation, but the peak bupivacaine level after 400 mg was low at 1.2 +/- 0.2-mu-g.ml-1. Thus, the technique of continuous intercostal nerve block described in this study is an effective treatment for the control of post-thoracotomy pain.
引用
收藏
页码:733 / 739
页数:7
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