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Related Experiment Videos

Pleural bupivacaine placement for optimal postthoracotomy pulmonary function: a prospective, randomized study

J Richardson1, S Sabanathan, R D Shah

  • 1Department of Anesthetics, Bradford Royal Infirmary, England.

Journal of Cardiothoracic and Vascular Anesthesia
|May 16, 1998
PubMed
Summary

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A (pain free) step in the right direction.

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Paravertebral bupivacaine administration resulted in better pulmonary function and lower chest tube losses compared to interpleural administration. Interpleural local anesthetic may impair respiratory function.

Area of Science:

  • Anesthesiology
  • Thoracic Surgery
  • Pulmonary Medicine

Background:

  • Chest tube administration of local anesthetics is used for postoperative pain management.
  • Paravertebral and interpleural routes are common techniques.
  • Differences in pulmonary function exist between these techniques.

Purpose of the Study:

  • To compare chest tube losses of bupivacaine between paravertebral and interpleural administration.
  • To elucidate the reasons for pulmonary function differences between the two techniques.

Main Methods:

  • Prospective, randomized study conducted at a single hospital.
  • Twelve adult patients undergoing posterolateral thoracotomies were included.
  • Bupivacaine was administered via either the paravertebral or interpleural route.

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Main Results:

  • Analgesia was comparable between groups, assessed by visual analog pain scores and morphine use.
  • Postoperative spirometric values were significantly better with paravertebral administration.
  • Chest tube bupivacaine losses were approximately four times higher in the interpleural group.

Conclusions:

  • Paravertebral administration offers superior pulmonary function outcomes.
  • Interpleural local anesthetic may negatively impact diaphragmatic and abdominal muscle function, impairing respiratory mechanics.
  • Higher chest tube losses with interpleural administration suggest reduced efficacy and potential for systemic or local adverse effects.