| Intrapleural intercostal nerve block associated with mini-thoracotomy improves pain control after major lung resection. | |
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MedLine Citation:
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PMID: 16481188 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Randomized Controlled Trial Date: 2006-02-14 |
Journal Detail:
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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:
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Created Date: 2006-04-28 Completed Date: 2006-07-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 790-4 Citation Subset: IM |
Affiliation:
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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 | |
Descriptor/Qualifier:
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Aged Female Humans Intercostal Nerves* Length of Stay Lung Diseases / surgery Lung Neoplasms / surgery Male Middle Aged Nerve Block / methods* Pain, Postoperative / prevention & control* Patient Satisfaction Pneumonectomy* / methods Postoperative Complications Thoracotomy* / adverse effects, methods |
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