Izvorni znanstveni članak
Intercostal Catheter Analgesia is More Efficient vs. Intercostal Nerve Blockade for Post-Thoracotomy Pain Relief
Jozo Kristek
Slavica Kvolik
Kata Šakić
Borislav Has
Lidija Prlić
Sažetak
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 mL of 0.5% bupivacaine injections twice a day by intercostal catheter. Intercostal
nerve blockade was performed using 5 mL of 0.5% bupivacaine. Intercostal nerve in thoracotomy wound, nerves below
and above thoracotomy wound was also injected. PaO2, PaCO2, FVC, FEV1 and visual analog pain scale (VAS) were obtained
preoperatively, 24, 48 and 72 hours after operation. Postoperative complications were recorded at the patient discharge.
Differences between groups were calculated using Mann-Whitney, KW test and chi square test. The arterial blood
gas analyses did not show statistically significant change in any group and time according to the baseline values. FVC
and FEV1 decreased significantly in both groups at first postoperative day according to baseline measurements. Patients
in B group had significantly higher FEV1 values in the third postoperative day (73.0511.25 in A vs. 83.509.17 in B
group, p<0.05). Intercostal catheter analgesia resulted in significantly lower postoperative VAS scores and reduced opioid
requirement as compared to intercostal nerve blockade. No differences in the postoperative complications were observed
between groups.
Ključne riječi
thoracotomy; pain; postoperative; analgesia; anesthetics; local; bupivacaine; catheter; nerve block
Hrčak ID:
27389
URI
Datum izdavanja:
10.4.2007.
Posjeta: 1.041 *