PERCUTANEOUS BILIARY DRAINAGE - CLINICAL-TRIAL OF ANALGESIA WITH INTERPLEURAL BLOCK

PURPOSE: To determine the analgesic efficacy and safety of interpleura l block for percutaneous biliary drainage. MATERIALS AND METHODS: In t his double-blind study, 34 age- and sex-matched patients who were to u ndergo percutaneous biliary drainage because of malignant biliary obst ruction were randomly assigned to the true-block group (30 mL 0.5% bup ivacaine block) or placebo-block group; all had access to a patient-co ntrolled analgesia (fentanyl) pump. Self medication, pain reports, blo od pressure, heart rate, and oxygen saturation were monitored during a nd until 8 hours after drainage. The McGill Pain Questionnaire was adm inistered 1 hour after biliary drainage. RESULTS: Patients in the plac ebo group self administered statistically significantly more fentanyl than did patients in the true-block group (P = .008). Peak pain scores (10-point scale) and McGill Pain Questionnaire stores were statistica lly significantly higher for the placebo group patients (P = .017 and P = .001, respectively). There were no differences between groups in t erms of blood pressure, heart rate, and oxygen saturation. Two patient s had pneumothorax caused by the interpleural block. CONCLUSION: Inter pleural block was effective in decreasing pain and opioid requirements during and after percutaneous biliary drainage and did not compromise the cardiopulmonary status of the patient. However, the rate of pneum othorax was higher than previously reported.