title: Single shot intercostal block for pain management in pediatric patients undergoing the Nuss procedure: a double-blind, randomized, controlled study.
abstract: OBJECTIVE
  The aim of this study was to investigate the efficacy of a single shot intercostal block for pain control in pediatric patients undergoing the Nuss procedure.
  
  
  METHODS
  A double-blind, randomized, controlled study was performed. Thirty patients received a single shot bilateral intercostal block with levobupivacaine (L group) and 30 patients with 0.9 % saline (S group). Standardized baseline analgesia was applied for all patients. Morphine consumption, pain scores, respiratory depression, nausea and vomiting, and urinary retention were recorded every 3h for 48h after surgery.
  
  
  RESULTS
  The loading dose of morphine was lower (p<0.00001) in the L group. There were significantly lower morphine doses up to 6h after surgery and VAS scores up to 3h after surgery in the L group (p<0.001 and p=0.0003, respectively). The incidence of nausea and vomiting was lower in the L group (<0.00001). The incidence of urinary retention was lower in the L group (p=0.019).
  
  
  CONCLUSIONS
  A single shot IB is an effective additional treatment for pediatric patients undergoing the Nuss procedure and results in the reduced consumption of morphine, less postoperative pain, and fewer opioid-related adverse effects.
authors.affiliation: Lithuanian University of Health Sciences, Medical Academy, Lithuania. Electronic address: lauralukos@gmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Lukosiene
authors.affiliation: Lithuanian University of Health Sciences, Medical Academy, Lithuania. Electronic address: andrius.macas@kaunoklinikos.lt.
authors.forename: Andrius
authors.initials: A
authors.lastname: Macas
authors.affiliation: Lithuanian University of Health Sciences, Medical Academy, Lithuania. Electronic address: trepenaitis@gmail.com.
authors.forename: Darius
authors.initials: D
authors.lastname: Trepenaitis
authors.affiliation: Lithuanian University of Health Sciences, Medical Academy, Lithuania. Electronic address: lina.kalibatiene@kaunoklinikos.lt.
authors.forename: Lina
authors.initials: L
authors.lastname: Kalibatiene
authors.affiliation: Lithuanian University of Health Sciences, Medical Academy, Lithuania. Electronic address: dalius.malcius@gmail.com.
authors.forename: Dalius
authors.initials: D
authors.lastname: Malcius
authors.affiliation: Lithuanian University of Health Sciences, Medical Academy, Lithuania. Electronic address: vidmantas.barauskas@kaunoklinikos.lt.
authors.forename: Vidmantas
authors.initials: V
authors.lastname: Barauskas
mesh_terms: D000293:Adolescent; D000779:Anesthetics, Local; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D005260:Female; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D007267:Injections; D007367:Intercostal Nerves; D000077554:Levobupivacaine; D008297:Male; D009407:Nerve Block / Q000379:methods*; D019637:Orthopedic Procedures / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D011300:Preoperative Care / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine
keywords: Intercostal block; Morphine; Nuss procedure; Pediatric; Postoperative pain