INTERCOSTAL NERVE BLOCKADE WITH A MIXTURE OF BUPIVACAINE AND PHENOL ENHANCE THE EFFICACY OF INTRAVENOUS PATIENT-CONTROLLED ANALGESIA IN THECONTROL OF POSTCHOLECYSTECTOMY PAIN

Prolonged nerve conduction blockade has been proposed to result from t he summed effects of charged and neutral local anaesthetics. Thirty-se ven patients were randomly allocated to receive intravenous patient-co ntrolled analgesia alone or combined with intercostal blockade (T7-T11 ) with a mixture of 0.45% bupivacaine and 0.6% phenol for post-cholecy stectomy analgesia. Adequacy of pain relief was measured by patient sc ores on a 10-cm visual analogue scale and by dose-demand ratio, amount s of loading dose and total consumption of morphine and also the durat ion of patient-controlled analgesia in each group. No differences were found between groups in post-operative scores, dose-demand ratios and loading doses of morphine. However, in the combined treatment group, a significantly lower total consumption of morphine (P<0.05), associat ed with a shorter duration of patient-controlled analgesia (P < 0.02) and a decreased mean number of unsuccessful demands (P < 0.001) were r ecorded. Intercoastal blockade with ine-phenolsupplementsintravenouspa tient-controlled analgesia for post-cholecystectomy pain relief.