Intrapleural bupivacaine analgesia in chest trauma: a randomized double-blind controlled trial

A randomized double-blind study was undertaken to investigate whether 0.25 per cent bupivacaine administered intrapleurally is an effective and reasonably safe method of obtaining analgesia in patients with thoracic injuries. A total of 120 patients complaining of pain after chest injury were entered into the trial. All had thoracostomy tubes already in situ. Of 60 patients who were given the test dose of bupivacaine intrapleurally, 37 obtained satisfactory pain relief for 2 or more hours compared with only 9 of 60 patients who received saline P less than 0.000001). Duration of analgesia in the test group (mean 3.9 h) was significantly longer than that in the control group (mean 0.9 h) P less than 0.005). There were no important side-effects attributable to the bupivacaine administered. We conclude that intrapleural bupivacaine is an effective and reasonably safe method for obtaining analgesia in patients who have chest drain tubes inserted.