Control of postoperative pain by intercostal nerve block in video-assisted thoracoscopic surgery.

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  • 胸腔鏡下手術における肋間神経ブロックの有用性に関する検討

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Although video-assisted thoracoscopic surgery (VATS) is widely used in the treatment of spontaneous pneumothorax as a less painful surgical approach, some patients complain of severe pain after VATS. The purpose of this study is to evaluate the efficacy of intercostal nerve block (ICB) with bupivacaine in VATS to decrease postoperative pain. We reviewed 80 patients who underwent VATS treatment of pneumothorax in our institution : 40 with ICB in VATS (group A) and remaining 40 without ICB (group B). No procedure-related complications on ICB occurred in group A. Chest tubes were removed on postoperative day 1 in all patients. Analgesic requirements were significantly decreased in group A than in group B not only on the operative day but also on the other postoperative days (group A, 0.6 times/day ; group B, 1.0 times/day, p =0.0018). Length of postoperative hospitalization was significantly shorter in the group A (group A, 3.3 days ; group B, 4.7 days, p = 0.0025). Our results indicate that ICB in VATS could relieve postoperative pain and allow earlier discharge. We conclude that ICB is useful and safe for control of postoperative pain in VATS.

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