AN EVALUATION OF INTERCOSTAL NERVE BLOCKADE FOR ANALGESIA FOLLOWING RENAL-TRANSPLANTATION

In a double-blinded study we examined the effect of supplementing pati ent-controlled morphine analgesia with intercostal nerve blockade to i dentify if this improved analgesia and reduced morphine requirements f ollowing renal transplantation. Fifty patients were randomized to rece ive unilateral intercostal nerve block with either 0.5% bupivacaine or saline to the lower five intercostal nerves. Each block was performed on the side of surgical incision following the completion of surgery. Patients receiving bupivacaine blockade reported reduced pain scores and used less morphine in the initial 4h following renal transplantati on, but did not demonstrate a significant reduction in overall pain sc ores, total 24h morphine requirements, or sedation scores. Two patient s developed a pneumothorax, neither of which were clinically apparent at the time of diagnosis, and only detected by chest radiography. A ch est radiograph should therefore be considered mandatory after intercos tal nerve blockade.