EFFICACY OF CONTINUOUS INTERCOSTAL BUPIVACAINE FOR PAIN RELIEF AFTER THORACOTOMY

We studied 20 patients undergoing thoracotomy, in a double-blind, plac ebo-controlled crossover trial of intercostal bupivacaine. Bupivacaine 0.25% was infused at 5 ml h-1 through each of two catheters placed in the intercostal space at operation. Mean (95% confidence limits) 24-h requirements for morphine from a patient-controlled analgesia device were 29 (22-37) mg during bupivacaine infusion and 44 (32-57) mg durin g saline infusion (P = 0.04). Patients also recorded significantly sma ller visual analogue scores for pain during bupivacaine infusion. Ther e were no adverse effects related to the intercostal infusion of bupiv acaine. We conclude that bupivacaine, infused through catheters placed during thoracotomy in the adjacent intercostal spaces, is a useful ad junct to systemic opioid analgesia