title: Use of intercostal bupivacaine with epinephrine after surgery to decrease use of narcotics and duration of intubation.
abstract: BACKGROUND
  Postoperative pain plays a significant part in the recovery of patients after open heart surgery.
  
  
  OBJECTIVE
  To determine if the use of intercostal bupivacaine with epinephrine is associated with decreases in use of narcotics and intubation times after open heart surgery.
  
  
  METHODS
  A randomly selected experimental group of 25 patients received injections of bupivacaine with epinephrine in the intercostal tissues before chest closure in open heart surgery. A control group of 22 patients received no bupivacaine, only standard care. Postoperative use of narcotics and intubation times were determined for both groups.
  
  
  RESULTS
  Compared with the control group, the group given bupivacaine with epinephrine used significantly less narcotics (P=.008) and had significantly shorter intubation times (P=.003).
  
  
  CONCLUSIONS
  Injection of intercostal bupivacaine with epinephrine before chest closure in open heart surgery decreases use of narcotics and length of intubation postoperatively, thus speeding up recovery times.
authors.affiliation: Saint Joseph Regional Medical Center, South Bend, Ind, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Fox
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Hughes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007366:Intercostal Muscles; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002045:Bupivacaine; D004837:Epinephrine