The comparison of intrapleural, intercostal and preemptive analgesia in postthoracotomy pain relief

Introductıon: Our purpose was to examine the effect of intrapleural analgesia, intercostal analgesia and preemptive analgesia in postthoracotomy pain. Materıal and Method: 36 ASA class II-III patients undergoing posterolateral thoracotomy were included in this study. Patients were randomly allocated into three groups. In Group I (no=12), 45mg (9mL) of bupivacaine + 50mg (1mL) of tramadol + 10 mL saline ( total volume 20 mL) was administered via intrapleural catheter. In Group II (no=12), 45mg (9mL) of bupivacaine + 50mg (1mL) of tramadol (total volume 10 mL) was administered to the intercostal nerves placed above and below of the incision. In Group III (no=12), preoperative 50 mg tramadol was given via intravenous route. Postoperative analgesia was maintained with V PCA with a 5 mg/h basal infusion rate throughout the first 24 h. During postoperative 48 h VAS and VRS values at rest and coughing, and additional analgesic requirements of patients were recorded. Results: The VRS values at coughing were significantly higher in Group III, compared with Group I (p<0.05). In Group III, additional analgesic requirement was significantly higher than Group I (p<0.05). Conclusion: We concluded that intrapleural and intercostal analgesia in postthoracotomy pain relief is more effective than preemptive analgesia. Key Words: Thoracotomy, Postoperative pain, Analgesia