Interpleural or thoracic epidural analgesia for pain after thoracotomy. A double blind study.
The analgetic effect of bupivacaine given epidurally or interpleurally after thoracotomy was investigated in a randomized, double blind, placebo controlled study. 32 patients with both an epidural and an interpleural catheter, were randomized to receive either interpleural or epidural analgesia. The interpleural group was given bupivacaine 5 mg.ml-1 with 5 microgram epinephrine as a 30 ml interpleural bolus, followed by a continuous infusion starting at a rate of 7 ml per hour and epidurally a bolus of 0.9% NaCl followed by a continuous infusion of 0.9% NaCl. The epidural group was given bupivacaine 3.75 mg.ml-1 with 5 microgram epinephrine as a 5 ml epidural bolus, followed by a continuous infusion starting at a rate of 5 ml per hour and interpleurally a bolus of 0.9% NaCl followed by a continuous infusion of 0.9% NaCl. The draining tubes were clamped during the injection of the interpleural bolus and 15 min afterwards. Adequacy of pain relief was evaluated with the Prins-Henry pain scale. Morphine requirement was registered, there was no difference between the groups in pain scores or need for additional morphine.
Brockmeier
V
V
Department of Anaesthesiology, Ullevål University Hospital, Oslo, Norway.
Moen
H
H
Karlsson
B R
BR
Fjeld
N B
NB
Reiestad
F
F
Steen
P A
PA
D000328:Adult; D000368:Aged; D000698:Analgesia; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000295:instrumentation; D002045:Bupivacaine / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010919:Placebos; D010994:Pleura; D013904:Thoracic Vertebrae; D013908:Thoracotomy / Q000009:adverse effects*; D013997:Time Factors
D010919:Placebos; D009020:Morphine; D002045:Bupivacaine