Efficacy of methods of intercostal nerve blockade for pain relief after thoracotomy.
Intercostal nerve blockade for postthoracotomy pain relief can be accomplished by continuous infusion of local anesthetics through a catheter in the subpleural space or through an interpleural catheter, by cryoanalgesia, and by a direct intercostal nerve block. A systematic review of randomized studies indicates that an extrapleural infusion is at least as effective as an epidural and significantly better than narcotics alone. The other techniques of intercostal blockade do not offer an advantage over narcotics alone.
Detterbeck
Frank C
FC
Division of Cardiothoracic Surgery, University of North Carolina, Chapel Hill, North Carolina 27599-7065, USA. fdetter@med.unc.edu
D000779:Anesthetics, Local / Q000008:administration & dosage; D002404:Catheterization / Q000379:methods; D017679:Cryotherapy / Q000379:methods; D004333:Drug Administration Routes; D006801:Humans; D007367:Intercostal Nerves; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology* / Q000628:therapy*; D010994:Pleura; D013908:Thoracotomy / Q000009:adverse effects*; D016896:Treatment Outcome
D000779:Anesthetics, Local