Extrapleural regional versus systemic analgesia for relieving postthoracotomy pain: a clinical study of bupivacaine compared with metamizol.
BACKGROUND
The effects of a local anesthetic delivered through a catheter inserted in the extrapleural region by a surgeon and an analgesic agent given systemically on pain after thoracotomy were assessed.


METHODS
The patients in group I (n = 25) had a catheter inserted between the parietal pleura and the endothoracic fascia by a surgeon, and 0.5% bupivacaine was given through this catheter. Another 25 patients (group II) had metamizol given intravenously. Respiratory function tests, arterial blood gases, range of shoulder motion, and postoperative pain were evaluated for each group. Bupivacaine and metamizol were given just before finishing the thoracotomy and then repeated every 4 hours for 3 days.


RESULTS
There was no statistical difference in arterial blood gases between the groups (P >.05). There were statistically significant differences in the respiratory function tests, range of shoulder motion, and visual analogue scale (P <.05) between the groups. Group I had fewer complications than group II. There was no mortality in either group.


CONCLUSIONS
Bupivacaine given through a catheter to the extrapleural region before finishing thoracotomy is substantially beneficial for the prevention of postoperative pain and reduction of postoperative complications.
Bilgin
Mehmet
M
Department of Thoracic Surgery, Erciyes University Medical Facility, Kayseri, Turkey. bilginm@erciyes.edu.tr
Akcali
Yigit
Y
Oguzkaya
Fahri
F
D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods; D000768:Anesthesia, General / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D002404:Catheterization; D004177:Dipyrone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011300:Preoperative Care; D011336:Probability; D012129:Respiratory Function Tests; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D019616:Thoracic Surgical Procedures / Q000379:methods; D013908:Thoracotomy / Q000009:adverse effects* / Q000379:methods
D004177:Dipyrone; D002045:Bupivacaine