PULMONARY COMPLICATIONS AFTER LUNG RESECTION - THE EFFECT OF CONTINUOUS EXTRAPLEURAL INTERCOSTAL NERVE BLOCK

被引：36

作者：

BERRISFORD, RG ^{[1
]}

SABANATHAN, SS ^{[1
]}

MEARNS, AJ ^{[1
]}

BICKFORDSMITH, PJ ^{[1
]}

机构：

[1] BRADFORD ROYAL INFIRM,DEPT THORAC SURG,DUCKWORTH LANE,BRADFORD BD9 6RJ,ENGLAND

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1990年 / 4卷 / 08期

关键词：

Intercostal block; Lung resection; Paravertebral block; Postoperative pulmonary complications;

D O I：

10.1016/1010-7940(90)90068-B

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

To assess the efficacy of continuous extrapleural intercostal nerve block (CEINB) with 0.5% bupivacaine on postoperative pain, pulmonary function and pulmonary complications, a prospective, randomised, double blind controlled trial was conducted on comparable patients under going lungresections; n = 21 (control), n = 25 (bupivacaine). The bupivacaine group required less papaveretum in the first 24 h (P < 0.01) and had lower pain scores over 5 postoperative days (P < 0.01). Pulmonary function recovered earlier in the bupivacaine group. Pulmonary complications occurred in 1 patient with normal lung function and 12 patients with obstructive airways disease (COAD): FEV1/FVC < 70%. There were no infusion-related complications. CEINB has been shown to be safe and effective in reducing postoperative pain and pulmonary complications. CEINB minimises the loss of lung function after thoracotomy and restores impaired pulmonary mechanics more rapidly. © Springer-Verlag.

引用

页码：407 / 411

页数：5

共 17 条

[1]

Alexander J.I., Spence A.A., Parikh R.K., Stuart B., The role of airway closure in postoperative hypoxaemia, Br J Anaesth, 45, pp. 34-40, (1973)

[2]

Bartlett R.H., Brennan M.L., Gazzangia A.B., Hanson E.L., Studies on the pathogenesis and prevention of postoperative pulmonary complications, Surg Gynecol Obst, 137, pp. 925-933, (1973)

[3]

Catley D.M., Thornton C., Jordan C., Lehane J.R., Royston D., Jones J.G., Pronounced episodic oxygen desaturation in the postoperative period: its association with ventilatory pattern and analgesic regimen, Anesthesiology, 63, pp. 20-28, (1985)

[4]

Conacher I.D., Paes M.L., Jacobson L., Phillips P.D., Heaviside D.W., Epidural analgesia following thoracic surgery, Anaesthesia, 38, pp. 546-551, (1983)

[5]

Engberg G., Wiklund L., Pulmonary complications after upper abdominal surgery: their prevention with intercostal blocks, Acta Anaesthesiol Scand, 32, pp. 1-9, (1988)

[6]

Gisvold S.V., Risk factors present before operation in order to assess operative risk, Acta Anaesthesiol Scand 33, 91, pp. 11-13, (1989)

[7]

Gunnarsson L., Hedenstierna G., Lundquist H., Tokics L., Chronic obstructive lung disease and anaesthesia - effect on gas exchange and atelectasis formation, Acta Anaesth Scand, 91, pp. 33-122, (1989)

[8]

Hasenbos M., Egmond J., Gielen M., Crul J.F., Postoperative analgesia by epidural versus intramuscular nicomorphine after thoracotomy, Acta Anaesthesiol Scand, 29, pp. 577-582, (1985)

[9]

Hedenstierna G., Strandberg A., Brismar B., Lundquist H., Svensson L., Tokics L., Functional residual capacity, thoracoabdominal dimensions and central blood volume during general anaesthesia with muscle paralysis and mechanical ventilation, Anesthesiology, 62, pp. 247-254, (1985)

[10]

Lutchen K.R., Saidel G.M., Primiano F.P., Horowitz J.G., Deal E.C., Mechanics and gas distribution in normal and obstructed lungs during tidal breathing, Am Rev Respir Dis, 130, pp. 974-979, (1984)

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