British Journal of Anaesthesia, Vol 75, Issue 5 541-547, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia
K. Perttunen, E. Nilsson, J. Heinonen, E. L. Hirvisalo, J. A. Salo and E. Kalso
Forty-five patients were allocated randomly to receive either a single
intrathoracic block of four intercostal nerves, a continuous thoracic
extradural infusion or a continuous paravertebral infusion of bupivacaine.
Patients were allowed additional i.v. boluses of morphine via a PCA device.
Segmental spread of pinprick analgesia was comparable in the groups for up
to 20 h. Up to 2 h after the block, plasma concentrations of bupivacaine
were greater in the intercostal group and there was large interindividual
variation. There were no significant differences between the groups in
pain, morphine consumption, respiratory function or adverse events.
Moderate to severe respiratory depression was detected in 14 patients more
than 2 h after operation.
CLINICAL INVESTIGATIONS
Extradural, paravertebral and intercostal nerve blocks for post- thoracotomy pain
Department of Clinical Pharmacology, Helsinki University Central Hospital, Paasikivenkatu 4, FIN-00250 Helsinki and Department of Anesthesia, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00290 Helsinki; Department of Anaesthesia, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00290 Helsinki; Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00290 Helsinki; Department of Clinical Pharmacology, University Central Hospital, Paasikivenkatu 4, FIN-00250 Helsinki
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