Abstract

Intercostal nerve blockage together with intravenous pain control analgesia (PCA) can be an easy and reliable method in diminishing post thoracotomy pain. In this prospective, randomized, controlled study, we aimed to investigate the effect of intercostal nerve blockage on post thoracotomy pain. We investigated 40 patients who had undergone thoracotomy in the period between May 2006-January 2007. Patients were divided into two groups. Group I (n=20) was dosed with dolantin (50 mg bolus, 5 mg PCA, 15 min. lock time) with PCA and tenoxicam (20 mg). Group II (n=20) was treated with intraoperative 5 segment intercostal nerve blockage (%0,5 bupivacaine 3 ml) in addition to (n=20) dolantin (50 mg bolus + 5 mg PCA, 15 min. lock time) with PCA . Tenoxicam visual analog scale (VAS) values at rest and duringcoughing, respiration rate, pulse rate, oxygen saturation, and blood pressure were observed at 0, 1, 2, 4, 8, 16, 24 hours. Total dolantin quantity used, analgesic demand amount and complications were recorded.

No statistical significant difference (p<0,05) could be found between the two groups from the demographical data such as respiration rate, pulse rate, oxygen saturation, complications, visual analog scale (VAS) values while at rest and coughing. However, the quantity of dolantin used (p=0,0043) and analgesic demand amount (p=0,0128) with PCA were significantly lower for group II in comparison to group I (p<0,05).

In conclusion, we are of the opinion that satisfactory analgesia could be obtained by applying intercostal blockage together with lower doses of narcotic analgesics in the treatment of post thoracotomy pain.