Efficacy of continuous extrapleural intercostal nerve block on post‐thoracotomy pain and pulmonary mechanics

  title={Efficacy of continuous extrapleural intercostal nerve block on post‐thoracotomy pain and pulmonary mechanics},
  author={Sabaratnam Sabanathan and Alan J Mearns and P. J. Bickford Smith and Jibah Eng and Richard G. Berrisford and Susan R. S. Bibby and M R Majid},
  journal={British Journal of Surgery},
To assess the efficacy of continuous extrapleural intercostal nerve block on postoperative pain and pulmonary function, a prospective, randomized, double‐blind, placebo‐controlled trial was conducted on 56 patients undergoing elective thoracotomy. Infusion was started before closing the chest and was continued for 5 days. Subjective pain relief was assessed on a linear visual analogue scale. Pulmonary function was measured on the day before operation and daily for 5 days. There were 29 patients… 

Continuous extrapleural intercostal nerve block and post-thoracotomy pulmonary complications.

It is concluded that continuous extrapleural intercostal nerve block is effective for post-thoracotomy analgesia and reduces pulmonary complications of thoracotomy in patients with chronic obstructive airways disease.

Continuous extrapleural intercostal nerve block after pleurectomy.

Continuous extrapleural intercostal nerve blockade with bupivacaine provides safe and effective postoperative analgesia and improves respiratory mechanics after pleurectomy.

A randomized controlled trial of continuous extra-pleural analgesia post-thoracotomy: efficacy and choice of local anaesthetic.

A randomized, prospective double-blind trial of two different local anaesthetic regimes to evaluate the effect of extrapleural infusion of local anaesthetics on post-thoracotomy pain relief and pulmonary function found lignocaine is equally as effective as bupivacaine and its use would result in some cost-saving.

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

It is concluded that in the early postoperative period there is no significant difference in pain relief in both the techniques but there after, epidural analgesia significantly reduces post thoracotomy pain.

Comparison of epidural analgesia and cryoanalgesia in thoracic surgery.

  • P. BrichonC. Pison R. Sarrazin
  • Medicine
    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • 1994

The effects of preoperative single-dose thoracic paravertebral block on acute and chronic pain after thoracotomy

It is indicated that adding PSTPVB to IV PCA improved acute postoperative pain and chronic pain in patients undergoing thoracotomy, but did not reduce the incidence of CPTP.

Extrapleural bupivacaine for amelioration of multiple rib fracture pain.

Results confirm that an indwelling, percutaneously placed intercostal catheter provides a continuous nerve block resulting in a simple, safe procedure that can ameliorate the pain and splinting associated with multiple rib fractures.



Postthoracotomy Pain and Pulmonary Function Following Epidural and Systemic Morphine

It is concluded that lumbar epidural morphine is highly effective in alleviating pain and improving respiratory function in postthoracotomy patients.


The aim of the present investigation was to study the lung function during the early postoperative period by means of dynamic spirometric methods and blood-gas analysis and the introduction of a new long-acting local anaesthetic, LAC 43*, without serious side effects, raised interest in this method of relief of pain.

Post-thoracotomy intercostal block: comparison of its effects on pulmonary function with those of intramuscular meperidine.

The study suggests that intercostal nerve block for post-thoracotomy analgesia offers some advantage in preserving effort-dependent pulmonary function when compared with postoperative narcotic analgesia.

Postoperative analgesia for thoracotomy patients.

It is demonstrated that intercostal nerve blocks can markedly reduce postoperative pain and improve pulmonary function in patients undergoing routine thoracotomies.

Cryoanalgesia for relief of pain after thoracotomy.

The technique of cryoanalgesia is simple, extremely effective, and apparently offers benefits not conferred by other methods of preventing pain after thoracotomy, which resulted in a low incidence of complications and a smooth recovery.

Pulmonary complications after upper abdominal surgery: their prevention with intercostal blocks

Irrespective of the type of incision, surgery or method of postoperative pain relief, the patients with PPC more often had respiratory or other disorders preoperatively or a surgical complication intra‐ or postoperatively than those with normal postoperative recovery.

Improved pain relief after thoracotomy: use of cryoprobe and morphine infusion.

Patients who had had intercostal nerves frozen with a cryoprobe or were given morphine by continuous intravenous infusion had significant less pain at rest than patients given intramuscular morphine.

Posterior intercostal nerve block for pain relief after cholecystectomy. Anatomical basis and efficacy.

The human intercostal space has been studied by excision of the posterior part of the rib cage at autopsy, followed by fixation, decalcification, section and staining, with no complications in the series.