Thoracoscopy as a nonpharmacotherapeutic research modification for limiting postoperative chest pain

Diminished tissue injury and shortened clinical recovery are benefits of us ing an endoscopic approach for patients needing operative procedure. In the course of developing an experimental model requiring procurement of topogr aphically precise lung biopsy specimens, we sought to apply thoracoscopy as a research alternative to thoracotomy. In addition, we investigated the in fluence of thoracoscopy on postprocedure recovery practices using rabbits d ivided into four treatment groups. Rabbit groups 1 and 2 underwent thoracos copy and lung biopsy while maintained by one-lung anesthesia. Additionally, group 2 had ketoprofen and bupivacaine HCl analgesics injected for treatme nt during postprocedure recovery. These two groups were compared to control rabbits in groups 3 and 4, which underwent inhalant anesthesia without tho racoscopy. Control group 3 also received the injection analgesic combinatio n. During recovery, rabbit behavior was systematically assessed for evidenc e of pain. No behavior considered indicative of pain needing intervention w as observed regardless of treatment group. Limited changes in plasma cortic osterone, catecholamines, and prostaglandin E-2 levels measured during reco very were difficult to associate with any treatment. Unexpectedly, signific antly different mean corticosterone and catecholamines levels were detected in rabbits given the injection analgesic combination in the absence of tho racoscopic procedure, as compared to other treatment groups. The results hi ghlight the importance of awareness that analgesic drug administration has the potential to alter homeostasis and affect interpretation of some study findings by its own guise. Correlation of the mean pain study results with plasma biochemical data supports preferential use of thoracoscopy as a refi nement for limiting postprocedural pain in research models.