Interpleural Catheter in the Management of Postoperative Pain

Kvalheim, Lars; Reiestad, Finn

doi:10.1097/00000542-198409001-00231

Cited by 73 publications

(17 citation statements)

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“…The deposition of local anaesthetic between the parietal and visceral pleura with the aim of producing an ipsilateral somatic block of multiple thoaracic dermatomes constitutes an interpleural block and was originally described by Kvalheim and Reiestad [132]. Unfortunately, the terminology used in the literature to describe this block can be confusing, some authors use the term intrapleural block [133] and others pleural block [134].…”

Section: Interpleural Blocksmentioning

confidence: 99%

Pain Management After Thoracic Surgery

Pennefather

McKevith

2011

Principles and Practice of Anesthesia for Thoracic Surgery

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Section: Interpleural Blocksmentioning

confidence: 99%

Pain Management After Thoracic Surgery

Pennefather

McKevith

2011

Principles and Practice of Anesthesia for Thoracic Surgery

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“…This technique, which is referred to as intrapleural block, was firstly published in 1986 10,11 using bupivacaine as a local anesthetic for surgeries on the upper abdominal surgeries 12 , and it has also been recently used in thoracic sympathectomy 9,13 . However, central nervous system toxicity was observed when bupivacaine was used in patients with pleural inflammation due to recent pneumonia, thus showing greater anesthetic absorption by injured tissue…”

Section: Introductionmentioning

confidence: 99%

Intrapleural analgesia after endoscopic thoracic sympathectomy

et al. 2011

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Brazil. Advisor and critical revision. ABSTRACT PURPOSE:To compare analgesia traditionally used for thoracic sympathectomy to intrapleural ropivacaine injection in two different doses. METHODS: Twenty-four patients were divided into three similar groups, and all of them received intravenous dipyrone. Group A received intravenous tramadol and intrapleural injection of saline solution. Group B received intrapleural injection of 0.33% ropivacaine, and Group C 0.5% ropivacaine. The following aspects were analyzed: inspiratory capacity, respiratory rate and pain. Pain was evaluated in the immediate postoperative period by means of the visual analog scale and over a one-week period. RESULTS: In Groups A and B, reduced inspiratory capacity was observed in the postoperative period. In the first postoperative 12 hours, only 12.5% of the patients in Groups B and C showed intense pain as compared to 25% in Group A. In the subsequent week, only one patient in Group A showed mild pain while the remainder reported intense pain. In Group B, half of the patients showed intense pain, and in Group C, only one presented intense pain. CONCLUSION: Intrapleural analgesia with ropivacaine resulted in less pain in the late postoperative period with better analgesic outcomes in higher doses, providing a better ventilatory pattern. Keywords: Intrapleural Analgesia. Sympathectomy. Thoracoscopy. RESUMO OBJETIVO:Comparar a analgesia tradicionalmente utilizada para simpatectomia videotoracoscópica à injeção intrapleural de ropivacaína em duas doses diferentes. MÉTODOS: Vinte e quatro pacientes foram distribuídos em três grupos semelhantes, e todos eles receberam dipirona endovenosa. O grupo A recebeu tramadol endovenoso e injeção intrapleural de solução salina. O grupo B recebeu injeção intrapleural de ropivacaína a 0,33%, e Grupo C ropivacaína a 0,5%. Os aspectos analisados foram: capacidade inspiratória, freqüência respiratória e dor. A dor foi avaliada no período pós-operatório por meio da escala visual analógica e durante o período de uma semana. RESULTADOS: Nos grupos A e B, a redução da capacidade inspiratória foi observada no período pós-operatório. Nas primeiras 12 horas de pós-operatório, apenas 12,5% dos pacientes nos grupos B e C apresentaram dor intensa em comparação a 25% no Grupo A. Na semana seguinte, apenas um paciente do grupo A apresentou dor leve, enquanto o restante relatou dor intensa. No Grupo B, metade dos pacientes apresentou dor intensa, e no Grupo C, apenas um apresentou intensa dor. CONCLUSÃO: A analgesia intrapleural com ropivacaína resultou em menos dor no pós-operatório tardio com os melhores resultados analgésicos nas doses mais altas, proporcionando um melhor padrão ventilatório. Descritores: Analgesia Intrapleural. Simpatectomia. Toracoscopia. Intrapleural analgesia after endoscopic thoracic sympathectomyActa Cirúrgica Brasileira -Vol. 26 (6) 5011 -509

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“…Kvalheirn et al introduced the intrapleural infusion of bupivacaine for postoperative pain control in patients having gall bladder, kidney, or breast surgery (Kvalheim & Reiestad 1984). The procedure has been extended to patients with thoracotomies (Rothstein et al 1986), and into the paediatric (Mc-Ilvaine, Chang & Jones 1988) and neonatal age groups (Bricker, Telford & Booker 1989).…”

Section: Introductionmentioning

confidence: 99%

The pharmacokinetics of bupivacaine following interpleural nerve block in infants of very low birthweight

Weston

Bourchier

1995

Pediatric Anesthesia

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Infants of very low birthweight (VLBW) who underwent thoracotomy were given 2.0 mg.kg-1 of bupivacaine by the intrapleural route, and serial blood levels were taken to determine the pharmacokinetic profile in this group of babies. It was apparent that the half life was longer, clearance lower, and volume of distribution greater than in term infants. Although the drug did not reach toxic levels at this dose, caution should be observed when redosing as the accumulation of the drug may be unpredictable.

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Interpleural Catheter in the Management of Postoperative Pain

Cited by 73 publications

References 0 publications

Pain Management After Thoracic Surgery

Pain Management After Thoracic Surgery

Intrapleural analgesia after endoscopic thoracic sympathectomy

The pharmacokinetics of bupivacaine following interpleural nerve block in infants of very low birthweight

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