Original articleIntrapleural bupivacaine ν saline after thoracotomy—effects on pain and lung function—a double-blind study
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Cited by (56)
Chronic cancer pain syndromes and their treatment
2022, Neurological Complications of Systemic Cancer and Antineoplastic TherapyRespiratory Chest Pain: Diagnosis and Treatment
2010, Medical Clinics of North AmericaCitation Excerpt :Their use for patients with acute pleuritic chest pain is limited but may have a role in those with neuropathic pain (eg, using tricyclic antidepressants or anticonvulsants)18 and persistent pain syndromes. The use of intrapleural local anesthetic agents for postoperative (eg, thoracotomy19–28 and sympathectomy29) and posttrauma pain30,31 has been studied with varying results. One randomized trial showed decreased pain with the use of intrapleural local anesthetic in patients with spontaneous pneumothorax.32
Chest Tube-Delivered Bupivacaine Improves Pain and Decreases Opioid Use After Thoracoscopy
2009, Annals of Thoracic SurgeryCitation Excerpt :Thoracic surgeons and anesthesiologists have tried various regional techniques to reduce postoperative discomfort. Several prospective, randomized studies showed benefits to intrapleural anesthetic deliveries [1–3; 7–9]. However, other investigators who attempted to replicate those results found that intrapleural bupivacaine alone could not lower the pain scores to acceptable levels, that a placebo effect was at play, and that the methodologies themselves were prone to considerable variations [10–12].
Efficacy of methods of intercostal nerve blockade for pain relief after thoracotomy
2005, Annals of Thoracic SurgeryCitation Excerpt :Other complications have included upper extremity tingling and urinary retention [42, 43]. Average plasma bupivacaine levels have generally been approximately 1 μg/mL (0.32 to 2.29 μg/mL) [33, 39, 42, 43, 45], but there is wide individual variation among patients [35]. The amount of bupivacaine lost in the chest tubes does not seen to correlate with either the plasma levels or the degree of pain relief [36, 37].
Double-blind comparison of intrapleural saline and 0.25% bupivacaine for ipsilateral shoulder pain after thoracotomy in patients receiving thoracic epidural analgesia
2005, British Journal of AnaesthesiaCitation Excerpt :We considered that, to be clinically useful, intrapleural bupivacaine would need to be safe and repeatable and thus effective after modest doses (1.5 mg kg−1). Peak plasma bupivacaine concentrations in patients undergoing thoracotomy who received 1.5 mg kg−1 of intrapleural bupivacaine (40 ml of bupivacaine 0.25% for a 70 kg patient) have been shown to be 1.50 μg ml−1.17 Increasing toxicity is seen with plasma bupivacaine levels above 2–4 μg ml−1.
Truncal Blocks: Intercostal, Paravertebral, Interpleural, Suprascapular, Ilioinguinal, and Iliohypogastric Nerve Blocks
2005, SPEC - Essentials of Pain Medicine and Regional Anesthesia (Reprint)
This article is accompanied by an editorial. Please see: Camporesi EM: Intrapleural analgesia: A new technique. J Cardiothorac Anesth 3:137–138, 1989.
Support was provided by the Anesthesia Department, University of Iowa Hospitals and Clinics CLINFO, and by Grant RR 59 from Clinical Research Centers Branch, NIH.