title: Intrapleural analgesia using ropivacaine for postoperative pain relief after minimally invasive thoracoscopic surgery.
abstract: OBJECTIVE
  to evaluate the efficacy and safety of intrapleural analgesia (IPA) using ropivacaine after thoracoscopic surgery, compared with thoracic epidural analgesia (TEA) using ropivacaine.
  
  
  METHODS
  forty patients undergoing thoracoscopic bullectomy for spontaneous pneumothorax were randomly assigned to one of two groups. IPA group (n = 20) received intermittent bolus injection of 0.375% ropivacaine into intrapleural space two times; at the end of operation and one more time as the pain increased. TEA group (n = 20) received continuous epidural analgesia with 0.375% ropivacaine. Transrectal diclofenac was administered as an additional analgesic. Pain was assessed on the basis of additional analgesics requirements and by using a visual analog scale (VAS).
  
  
  RESULTS
  the time courses of VAS scores along the postoperative time course were not significantly different (p = 0.175). Consumption of transrectal diclofenac was significantly smaller in IPA group (p = 0.025). No major complications appeared in both groups, and incidence of adverse symptoms was not different.
  
  
  CONCLUSIONS
  in IPA group, pain was managed with less consumption of additional analgesics. IPA could be one of the good choices after thoracoscopic surgery for its efficacy, safety, and benefit of easy placement of the catheter.
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. yokkun.ishikawa@w3.dion.ne.jp
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Maehara
authors.forename: Teppei
authors.initials: T
authors.lastname: Nishii
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Adachi
authors.forename: Shizu
authors.initials: S
authors.lastname: Saito
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D015360:Analgesia, Epidural / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D004008:Diclofenac / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D055770:Interpleural Analgesia / Q000379:methods*; D008297:Male; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D000077212:Ropivacaine; D013906:Thoracoscopy / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D000077212:Ropivacaine