Abstract
PERINEURAL INTERCOSTAL INJECTION OF BUPIVACAINE FOR POST-OPERATIVE ANALGESIA IN THORACIC SURGERY

Pushpa Ashok Kamble, Mayuri Khobragade Kamble, Ashok Tarachand Kamble, Pratik Abhishek* and Priyansh Pandey

ABSTRACT

Introduction: The pain that occurs following a thoracotomy procedure, which is also known as post-thoracotomy pain, is quite commonly very severe and a major source of concern in the post-operative period. The present study is done to see the response of intercostal nerve blockade with injection bupivacaine for acute post-thoracotomy pain relief. Materials and Methods: A total of 20 patients undergoing elective thoracotomy procedures for various conditions were studied. In all the surgeries incision was placed in the 5th intercostal space so that it overlies pulmonary hilum to have a better injection site. Results: Total of 20 patients undergoing thoracotomy were included in this study. 60% of patients were relieved of major pain by injection bupivacaine. 10% patients required tramadol. Rest of the patients required analgesia only for 24-48 hours. Conclusion: Bupivacaine is a long acting analgesic and by injection into perineural space of intercostal nerves it remains there for long time producing analgesia. This improves chest compliance, adequate oxygenation and less of oozing. So it is recommended that post operative perineural injection of bupivacaine has an additional advantage of production of post operative analgesia and reduce the demand of another analgesia.

Keywords: Intercostal nerve blockade, Post-thoracotomy pain, Bupivacaine, Thoracotomy.


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