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Low volume intercostal injection. A comparative study in patients and cadavers
1Department of Anaesthesia, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories.
Anaesthesia
|August 1, 1988
Summary
Injecting local anesthetic in the intercostal space showed similar spread in patients and cadavers. For effective pain management, individual intercostal nerve blocks are still necessary when using low anesthetic volumes.
Area of Science:
- Anesthesiology
- Anatomy
Background:
- Intercostal nerve blocks are crucial for thoracic pain management.
- Understanding local anesthetic spread is vital for optimizing block efficacy and safety.
Purpose of the Study:
- To compare the spread of bupivacaine-methylene blue in the intercostal space between living patients and cadavers.
- To evaluate the necessity of individual intercostal nerve blocks for low-volume local anesthetics.
Main Methods:
- 51 successful intercostal space injections were performed in both patient and cadaver groups.
- A solution of 3 ml bupivacaine-methylene blue was used for all injections.
- The extent of anesthetic spread was assessed in each group.
Main Results:
- Spread was confined to a single intercostal space in 86% of patient injections and 84% of cadaver injections.
- More extensive spread was observed in cadavers, likely due to autolysis.
- No significant difference in spread confined to one space was found between groups.
Conclusions:
- Local anesthetic spread in the intercostal space is largely confined to one segment in both patients and cadavers.
- Individual intercostal nerve blockade remains essential for effective pain control with low anesthetic volumes.
- Cadaveric changes may influence anesthetic spread patterns.