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Intercostal nerve block with Bupivacaine for post-thoracotomy pain relief in children
P Matsota1, S Livanios, E Marinopoulou
1Department of Anaesthesia, Children's Hospital A. & P. Kyriakou, Athens, Greece.
Insights
Intercostal Nerve Block with Bupivacaine provides effective pain relief after pediatric thoracotomy. This safe analgesia method reduced pain and side effects compared to traditional pain management.
Area of Science:
- Pediatric Anesthesiology
- Thoracic Surgery
- Pain Management
Background:
- Post-thoracotomy pain in children requires effective management.
- Opioid analgesics can cause significant side effects in pediatric patients.
Purpose of the Study:
- To evaluate the efficacy of Intercostal Nerve Block (ICB) using Bupivacaine (BUP) for postoperative analgesia in children undergoing thoracotomy.
Main Methods:
- A randomized study of 20 children (5-12 years) undergoing thoracotomy.
- Group 1 received ICB with Bupivacaine and epinephrine.
- Group 2 (control) received intravenous meperidine.
Main Results:
- Bupivacaine group showed a significantly longer duration of analgesia (p < 0.001).
- No Bupivacaine toxicity observed.
- Control group experienced a high incidence of nausea and vomiting (p < 0.005).
Conclusions:
- ICB with Bupivacaine offers safe and satisfactory analgesia for the early postoperative period after pediatric thoracotomy.
- ICB is a superior alternative to systemic opioids for managing post-thoracotomy pain in children.
Abstract:
The purpose of the study is to evaluate the efficacy of Intercostal Nerve Block (ICB) with Bupivacaine (BUP) to produce satisfactory analgesia after thoracotomy in children. We studied 20 children aged between 5 and 12 years, scheduled for thoracotomy under general anaesthesia. The children were randomly divided into two groups. In the first group (n = 10) 3 mg/kg BUP 0.5 % with epinephrine 1 : 200 000 was injected by the surgeon under direct vision, into the intercostal space where thoracotomy was performed. In the control group (n = 10) meperidine 1 mg/kg was administered i.v. at the same surgical time, and afterwards the chest was closed. Postoperatively the vital signs, the side effects and the total postoperative analgesic requirements were recorded. The mean duration of postoperative analgesia produced was longer in the BUP group (p < 0.001). None of the children in BUP group suffered from BUP toxicity, while in the control group a high incidence of vomiting and nausea was noticed (p < 0.005). It is concluded that ICB with BUP produces satisfactory and safe analgesia for the early postoperative period after thoracotomy in children.