PAIN RELIEF FOR THORACOTOMY - COMPARISON OF MORPHINE REQUIREMENTS USING AN EXTRAPLEURAL INFUSION OF BUPIVACAINE

Background and Objectives. The effectiveness of a continuous infusion of extrapleural bupivacaine for relief of postoperative pain was asses sed in patients undergoing posterolateral thoracotomy under general an esthesia by comparing morphine requirements. Methods. Bupivacaine 0.25 % was infused at a rate of 5 mL/h through an unkinkable extrapleural c atheter that was sited under direct vision at operation. Results. Mean (+/- SD) 24-hour requirements for morphine from a patient-controlled analgesia device were 39 +/- 15 mg for the treated group and 69 +/- 26 mg in the control group (P < .006). Patients in the treated group rec orded significantly smaller visual analog scores for pain both at rest (P < .005) and on movement (P < .03) compared to the control group. T here were no adverse effects associated with the use of extrapleural b upivacaine in this study. Conclusions. Continuous extrapleural infusio n of bupivacaine through unkinkable catheters sited during thoracotomy resulted in decreased intravenous patient-controlled analgesia use an d decreased verbal categoric pain scores at rest and during movement.