scholarly journals Intrapleural intercostal nerve block associated with mini-thoracotomy improves pain control after major lung resection☆

2006 ◽  
Vol 29 (5) ◽  
pp. 790-794 ◽  
Author(s):  
Antonio D’Andrilli ◽  
Mohsen Ibrahim ◽  
Anna Maria Ciccone ◽  
Federico Venuta ◽  
Tiziano De Giacomo ◽  
...  
Keyword(s):  
Nerve Block ◽  
Pain Control ◽  
Lung Resection ◽  
Intercostal Nerve ◽  
Intercostal Nerve Block ◽  
Mini Thoracotomy

scholarly journals Continuous Extrapleural Intercostal Nerve Block for Post Thoracotomy Analgesia in Children

1997 ◽  
Vol 25 (4) ◽  
pp. 390-397 ◽  
Author(s):  
C. S. Downs ◽  
M. G. Cooper
Keyword(s):  
Nerve Block ◽  
Lung Resection ◽  
Postoperative Nausea And Vomiting ◽  
Intercostal Nerve ◽  
Parietal Pleura ◽  
Intercostal Nerve Block ◽  
Regional Analgesia ◽  
Morphine Infusion ◽  
Opioid Administration ◽  
Intercostal Nerves

The safety and efficacy of continuous extrapleural intercostal nerve block has been well established in adults. This review of our initial paediatric experience suggests a role for this technique in children and discusses risks and benefits relative to other forms of regional analgesia for thoracotomy. Nine children aged one to twelve years received extrapleural infusions of bupivacaine 0.1-0.2% following lateral thoracotomy for lung resection. An extrapleural catheter was placed by the surgeon prior to thoracotomy closure, and correctly positioned under direct vision external to the parietal pleura alongside the vertebral column. An intraoperative loading dose of bupivacaine, 0.25-0.5% (0.28±0.1 ml/kg, mean±SD) was injected so as to raise a bleb under the parietal pleura which spread longitudinally to bathe several intercostal nerves in the paravertebral gutter. The chest wall was then closed. Infusions of bupivacaine were commenced in the recovery room and continued at a constant rate of 0.21±0.09 ml/kg/h for 72±15 hours. The mean dose of bupivacaine was 284±97 μg/kg/h. Patients also received standard analgesia as an intravenous morphine infusion (10-50 μg/kg/h), or patient-controlled analgesia. Nursing staff were specifically instructed not to alter their usual management of variable rate morphine infusions which are titrated to adequate analgesia. Morphine requirements in the first 48 postoperative hours remained less than 30 μg/kg/h, oral fluids were well tolerated after 31.2±19.1 hours, nasogastric tubes were removed at 16.7±11.2 hours. Postoperative nausea and vomiting and respiratory depression were not observed in any patient and all were able to comply with physiotherapy. There were no complications of catheter placement or bupivacaine administration. Our initial experience suggests that this is a safe technique which minimizes complementary opioid administration and provides adequate analgesia for children postthoracotomy for lung resection.

scholarly journals Postoperative Pain Control by Intercostal Nerve Block After Augmentation Mammoplasty

2017 ◽  
Vol 41 (5) ◽  
pp. 1031-1036 ◽  
Author(s):  
Chang Min Kang ◽  
Woo Jeong Kim ◽  
Sean Hyuck Yoon ◽  
Chul Bum Cho ◽  
Jeong Su Shim
Keyword(s):  
Postoperative Pain ◽  
Nerve Block ◽  
Pain Control ◽  
Intercostal Nerve ◽  
Augmentation Mammoplasty ◽  
Postoperative Pain Control ◽  
Intercostal Nerve Block

scholarly journals Pain Control After Mastectomy in Transgender Patients: Ultrasound-guided Pectoral Nerve Block II Versus Conventional Intercostal Nerve Block: A Randomized Clinical Trial

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Faranak Rokhtabnak ◽  
Soheila Sayad ◽  
Maryam Izadi ◽  
Soudabeh Djalali Motlagh ◽  
Poupak Rahimzadeh
Keyword(s):  
Clinical Trial ◽  
Hospital Stay ◽  
Pain Intensity ◽  
Nerve Block ◽  
Pain Control ◽  
Intercostal Nerve ◽  
Type Ii ◽  
Ultrasound Guided ◽  
Intercostal Nerve Block ◽  
Pectoral Nerve

Background: Mastectomy is sometimes performed in transgender patients, which may damage the regional nerves such as the pectoral and intercostobrachial nerves, leading to postoperative pain. An ultrasound-guided nerve block can be used to track and block the nerves properly. Objectives: This study aimed to compare the ultrasound-guided type-II pectoral nerve block with the blind (conventional) intercostal nerve block (ICNB) for pain control after breast tissue reconstruction surgery in transgender patients. Methods: In the present single-blind randomized clinical trial, 47 patients were randomly divided into two groups: (A) Ultrasound-guided type-II pectoral nerve block (n = 23) and (B) blind intercostal nerve block (n = 24). After nerve block in both groups, pain intensity at 3, 6, 12, and 24 hours after surgery, upper limb paresthesia, frequency of nausea and vomiting, shortness of breath, hematoma, and the length of hospital stay were assessed. Results: Patients who received the ultrasound-guided type-II pectoral nerve block had a greater reduction in pain intensity (24 h after surgery), opioid use (24 h after surgery), nausea, vomiting, and hospital stay than those who received ICNB, whereas the recovery time did not differ between the study groups. Conclusions: The pectoral nerve block under ultrasound guidance, compared to the intercostal nerve block, in transgender patients can reduce the required dosage of opioids within 24 hours, pain intensity within 24 hours after surgery, the incidence of postoperative nausea, and vomiting, and the hospital stay of patients.

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