Intercostal nerve blockade versus thoracic epidural analgesia for post thoracotomy pain relief

Sanjay, OP; Prashanth, P; Tauro, DI

doi:10.1007/s12055-003-0003-6

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…In summary, our study is in agreement with several previous studies [9,16,19]; however, other studies have found that intercostal block is a good alternative to thoracic epidural analgesia, as it is associated with similar pain scores and morphine consumption during the first 24 postoperative hours [4,9,[12][13][14].…”

Section: Discussionsupporting

confidence: 93%

“…In a series of patients who underwent lung resection, forty cases with thoracic epidural or intercostal block pain relief therapy using 0.25% bupivacaine were compared. In this study, non-steroidal analgesic consumption and pain scores in the epidural group were significantly lower than in the intercostal group [19]. In a study by Concha et al [4] 16 patients (group 1) received a 5-segment intercostal block plus intravenous patient-controlled analgesia (PCA) morphine, whereas 15 patients (group 2) received PCA bupivacaine and fentanyl infusions through thoracic epidural catheters.…”

Section: Discussionmentioning

confidence: 54%

“…Urinary retention is an adverse effect of the use of both epidural catheters and opioid analgesics, but we were not able to observe this clinical finding, as all our patients had urinary catheters during the first 24 postoperative hours [19,23,27].…”

Section: Discussionmentioning

confidence: 71%

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Anaesthesiology and intensive care Comparison of continuous use of thoracic epidural analgesia and intercostal block for pain management after thoracotomy

Sagiroglu¹,

Baysal²,

Kiraz³

et al. 2013

kitp

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StreszczenieCel pracy: Celem pracy było porównanie skuteczności ciągłe-go stosowania znieczulenia zewnątrzoponowego piersiowego oraz blokady międzyżebrowej do leczenia bólu po torakotomii. Materiał i metody: Sześćdziesięciu chorych ukończyło prospektywne badanie z randomizacją przeprowadzone metodą podwójnie ślepej próby. Pacjentów losowo przydzielono do grupy otrzymującej piersiowe znieczulenie zewnątrzoponowe (grupa 1., n = 30) lub blokadę międzyżebrową (grupa 2., n = 30) przez 24 godziny. W obu grupach podawano bupiwakainę o stężeniu 0,25% w ilości 5 ml/godzinę przy użyciu cewnika. W celu oceny bólu użyto wizualnej skali analogowej w spoczynku (VAS-R) i po kaszlu (VAS-C). Wyniki pobrano na począt-ku badania, jak również 1, 6 i 24 godziny po zabiegu. Zebrano także dane dotyczące zużycia morfiny, powikłań i efektów niepożądanych. Wyniki: Wartości VAS-R i VAS-C na początku były podobne, jednak wyniki uzyskane po upływie 1, 6 i 24 godzin były znacząco niższe w grupie 1. niż w grupie 2. (odpowiednio p = 0,017, p = 0,001, p = 0,023 dla VAS-R oraz p = 0,006, p = 0,002, p = 0,032 dla VAS-C). Zużycie morfiny na 24 godziny w grupie 1. było niższe w porównaniu z grupą 2. (p = 0,032). W grupie 1 u 5 z 30 pacjentów (17%) wystąpiło niedociśnienie, w grupie 2. nie zanotowano takich przypadków (p = 0,02). Wniosek: W przypadku bólu po torakotomii lepszą kontrolę analgezji uzyskuje się za pomocą znieczulenia zewnątrzopo-nowego piersiowego, jednak blokada międzyżebrowa stanowi alternatywę, ponieważ jest związana z mniejszą częstością występowania niedociśnienia. Słowa kluczowe: ból, torakotomia, znieczulenie zewnątrzopo-nowe piersiowe, blokada nerwu międzyżebrowego. Kardiochirurgia i Torakochirurgia Polska 2013; 10 (3) 244 ANAESTHESIOLOGY AND INTENSIVE CARE AbstractAim of the study: We aimed to compare the efficacy of the continuous use of thoracic epidural and intercostal analgesia for post-thoracotomy pain. Material and methods: Sixty patients completed a prospective, randomized, double-blinded study. The patients were randomized to receive thoracic epidural (group 1, n = 30) or intercostal block (group 2, n = 30) for 24 hours. In both groups, 0.25% bupivacaine was infused at a rate of 5 ml/h through an inserted catheter. Visual analog scale at rest (VAS-R) and after coughing (VAS-C) scores were recorded at baseline and at 1, 6 and 24 hours after surgery to evaluate pain. Morphine consumption, complications and side effects were recorded as well. Results: VAS-R and VAS-C scores were similar at baseline; however, 1 st , 6 th and 24 th hour scores of group 1 were significantly lower than the scores of group 2 (for VAS-R; p = 0.017, p = 0.001, p = 0.023, for VAS-C; p = 0.006, p = 0.002, p = 0.032, respectively). 24-hour morphine consumption was lower in group 1 in comparison to group 2 (p = 0.032). In group 1, 5 out of 30 patients (17%) experienced hypotension, compared with none in group 2 (p = 0.02). Conclusions: For post-thoracotomy pain, better control of analgesia is observed with the thoracic epidural technique; however, i...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 54%

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Anaesthesiology and intensive care Comparison of continuous use of thoracic epidural analgesia and intercostal block for pain management after thoracotomy

Sagiroglu¹,

Baysal²,

Kiraz³

et al. 2013

kitp

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“…Sanjay et al . compared ICNB using 0.25% bupivacaine versus thoracic epidural analgesia for postthoracotomy pain relief and found that the effect of intercostal nerve block would wear off after 4 h.[ 10 ] Taylor et al . reported good quality analgesia for a median duration of 16 h with a significant reduction in morphine requirements with bupivacaine 0.375%.…”

Section: Discussionmentioning

confidence: 99%

Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial

2017

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Background:The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS.Materials and Methods:Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward.Results:The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours.Conclusion:Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period.

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“…ICNBs are generally administered as single injections at least two dermatomes above and below the thoracotomy incision [12].…”

Section: C)mentioning

confidence: 99%

The Optimal Pain Management Methods Post Thoracic Surgery: A Literature Review

Bithas

Papaleontiou

Sokal

et al. 2019

SCSOAJ

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Post-operative pain control is one of the key factors that can aid in fast and safe recovery after any surgical interventions. Thoracic surgery can cause significant postoperative pain which can lead to delayed recovery, delayed hospital discharge and possibly increased risk of chest complications in the form of atelectasis and even lower respiratory infections. Therefore, appropriate pain management following thoracic surgery is mandatory to prevent development of such morbidities including chronic pain.

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Intercostal nerve blockade versus thoracic epidural analgesia for post thoracotomy pain relief

Abstract: Background: Post thoracotomy pain is a major source of concern in the postoperative period. The purpose of

Cited by 5 publications

References 15 publications

Anaesthesiology and intensive care Comparison of continuous use of thoracic epidural analgesia and intercostal block for pain management after thoracotomy

Anaesthesiology and intensive care Comparison of continuous use of thoracic epidural analgesia and intercostal block for pain management after thoracotomy

Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial

The Optimal Pain Management Methods Post Thoracic Surgery: A Literature Review

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