Document Detail

Intrapleural intercostal nerve block associated with mini-thoracotomy improves pain control after major lung resection.
MedLine Citation:
PMID:  16481188     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To prospectively assess the impact of intrapleural intercostal nerve block (IINB) associated with mini-thoracotomy on postoperative pain and surgical outcome after major lung resections. METHODS: Between January 2004 and February 2005, we randomly assigned 120 consecutive patients undergoing mini-thoracotomy (10-13 cm) for major lung resections, to receive or not IINB from the 4th to the 8th space at the moment of thoracotomy using 20 ml (7.5 mg/ml) ropivacain injection at the dose of 4 ml for each space. Postoperative analgesia consisted of continuous intravenous infusion of tramadol (10 mg/h) and ketoralac tromethamine (3 mg/h) for 48 h for all patients. RESULTS: The two groups (60 patients each) were comparable for age, sex, pulmonary function, type and duration of the procedure. Mortality and morbidity were 0% and 10%, respectively, for the IINB group and 3.3% and 15%, respectively, for the non-IINB group (p>0.05, NS). Mean postoperative pain measured by the 'Visual Analogue Scale' were as follows: 2.3+/-1 at 1 h, 2.2+/-0.8 at 12 h, 1.8+/-0.7 at 24 h, and 1.6+/-0.6 at 48 h for the IINB group; and 3.6+/-1.4 at 1 h, 3.4+/-2 at 12 h, 2.9+/-1.2 at 24 h, and 2.0+/-1 at 48 h for the non-IINB group. Differences were significant at 1 h, 12 h, 24 h, and 48 h (p<0.05). Mean postoperative hospital stay was 5.7 days in the IINB group and 6.5 days in the non-IINB group (p<0.05). CONCLUSION: IINB associated with mini-thoracotomy reduces postoperative pain and contributes to improve postoperative outcome after major pulmonary resections.
Antonio D'Andrilli; Mohsen Ibrahim; Anna Maria Ciccone; Federico Venuta; Tiziano De Giacomo; Domenico Massullo; Giovanni Pinto; Erino A Rendina
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-02-14
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  29     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-28     Completed Date:  2006-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  790-4     Citation Subset:  IM    
Department of Thoracic Surgery, University of Rome La Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy.
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MeSH Terms
Intercostal Nerves*
Length of Stay
Lung Diseases / surgery
Lung Neoplasms / surgery
Middle Aged
Nerve Block / methods*
Pain, Postoperative / prevention & control*
Patient Satisfaction
Pneumonectomy* / methods
Postoperative Complications
Thoracotomy* / adverse effects,  methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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