Analgesia and respiratory function following intrapleural bupivacaine after cholecystectomy

Analgesia and pulmonary function following intrapleural bupivacaine were compared with those following intramuscular pethidine in thirty-four patients after cholecystectomy. The patients were randomly allocated to two groups of seventeen patients each to receive either intrapleural bupivacaine or intramuscular pethidine. The positions of seventeen intrapleural catheters inserted were confirmed by chest radiography. Two out of seventeen catheters were found to be located in the extrapleural space. It was also recognized by fluoroscopy that phrenic nerve palsy did not develop on patients given intrapleural bupivacaine. The subjective quality of analgesia following intrapleural bupivacaine was significantly better than that following intramuscular pethidine. The mean duration of analgesia obtained after each injection of bupivacaine was 4.68 hr (range 3.5-6.1 hr). Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV 1), which decreased markedly in the postoperative period improved significantly after being given bupivacaine or pethidine. But there was no significant difference in the improvement of FVC and FEV 1, between both groups in spite of the higher percentage of pain relief in the intrapleural bupivacaine group. All respiratory function tests studied thirty days after surgery were not significantly different when compared with those before surgery.