[Postoperative analgesia for nephrectomy]

The aim of this study of post-nephrectomy acute pain in 30 patients was to compare three methods of postoperative analgesia and determine which one could be the most satisfactory. Ten patients received epidural analgesia with pethidine (400 mg.24 h-1 for 48 hrs). Ten other patients received intrapleural analgesia with bupivacaine (0.2 mg.kg-1.h-1 of 0.5% bupivacaine with 1/200,000 epinephrine). The ten remaining patients received systemic IV analgesia (2 g of propacetamol every 6 hrs and 0.15 mg of buprenorphine every 6 hrs). According to results of pain evaluation score (VAS) epidural analgesia with pethidine (VAS less than 2.5) appeared to be the best tested analgesic method. IV systemic analgesia (VAS less than 5) was less effective. Intrapleural bupivacaine (VAS greater than 5) was ineffective but apparently not toxic (serum concentration less than 1,200 ng.ml-1).