Blood-stained pleural effusion complicating interpleural analgesia.
A case of blood-stained pleural effusion complicating interpleural analgesia for a difficult nephrectomy is reported. We describe our technique of placement of the interpleural catheter. Interpleural infusion of 0.25% bupivacaine at 7 mls/h provided excellent postoperative analgesia. However, a left pleural effusion was demonstrated from chest X-ray films taken from the third day post-operatively. Persistent low grade fever and a large pleural effusion necessitated drainage which resulted in improvement in symptoms. Possible aetiologies of the effusion are discussed, although the exact cause was uncertain. Observation for a developing pleural effusion and other complications should form part of the postoperative observation and if one does develop, the necessary measures can be taken.
Khor
K E
KE
Department of Anaesthesia, Wellington Hospital, New Zealand.
Josephson
M A
MA
D000698:Analgesia / Q000009:adverse effects*; D016058:Analgesia, Patient-Controlled; D001769:Blood; D002045:Bupivacaine / Q000008:administration & dosage*; D002404:Catheterization / Q000295:instrumentation; D004322:Drainage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods; D010994:Pleura; D010996:Pleural Effusion / Q000209:etiology* / Q000601:surgery
D009020:Morphine; D002045:Bupivacaine