INTERPLEURAL ANALGESIA FOR POSTOPERATIVE PAIN RELIEF IN RENAL SURGERYPATIENTS

The feasibility of interpleural analgesia for postoperative pain relie f after renal surgery using anterior intercostal incision was studied in 16 adult patients. 20 ml bupivacaine plain 5 mg/ml In ten patients, and the same dose of bupivacaine with epinephrine 5 mu g/ml in six pa tients, was injected through epidural catheter into the pleural space of the operated side, maximally three times per 24 hours. As additiona l pain medication, oxycodone i.m. was given if needed. In ten control patients, oxycodone was the only pain medication. Postoperative pain r elief in patients who received interpleural bupivacaine plain was exce llent in four, moderate in four and poor in two cases. For supplementa l pain relief the patients were given 2.1 +/- 1.1 (SEM) injections of oxycodone during the three days. Control patients received, respective ly. 11.6 +/- 0.7 injections of oxycodone, and they considered the pain relief excellent in six and moderate in four cases. Median duration o f interpleural analgesia was in bupivacaine plain cases 6 h (range 2-1 4 h) and in bupivacaine with epinephrine 7 h (range 4-15 h). The mean peak serum concentration of bupivacaine plain was 1868 +/- 168 ng/ml, and that of bupivacaine with epinephrine 1312 +/- 273 ng/ml. No compli cations were seen. The results suggest that interpleural analgesia obt ained by 20 ml bupivacaine 5 mg/ml three times a day gives most patien ts good pain relief.