Comparison of intercostal nerve blockage versus local anesthesia for tube thoracostomy insertion; a randomised controlled trial. (October 2022)

• Record Type: Journal Article
• Authors: Mousavi, Noushin; Davoodabadi, Abdulhossein; Izadian, Mohammadhasan; Mehran, Saeed Mohseni; Aminipour, Mohammadreza; Hajian, Abbas
• Is Part Of: International journal of surgery open. Volume 47(2022)
• Publication Date: 2022-10
• Subjects: Bupivacaine -- Intercostal nerve -- Local anesthesia -- Nerve block -- Tube thoracostomy; Surgery -- Periodicals; 617.005
• DOI: 10.1016/j.ijso.2022.100535
• Languages: English
• ISSNs: 2405-8572

Abstract

Abstract: Background: Tube thoracostomy (TT) insertion is common and painful. Since thoracic pain concludes to lung atelectasis and following disadvantages, therefore pain control is fundamental. There is no general consensus on any analgesic method in this regard. This study aims to compare intercostal nerve blockage (ICNB) and local anesthesia (LA) considering postoperative effects. Method: This is a randomized controlled double-blinded survey. Eligible conscious subjects were selected randomly from non-traumatic patients who were admitted in hospital but not candidate for further surgery. The only surgical intervention was a classic TT insertion. Preoperative anesthesia was conducted through ICNB or LA approach with total 15 mL bupivacaine 0.5% for every patient. Severity of pain was demonstrated using visual analogue scale method for five times. Also total administered opioid was registered. Results: Data was adopted from 64 eligible patients. There was no difference between demographic variables(P > 0.05). Pain significantly mitigated following ICNB during TT insertion and also last for at least 6 h after surgery(p < 0.001). Additionally, cumulative dose of prescribed pethidine after ICNB was obviously lower than when LA approach was conducted(p < 0.001). There was no remarkable postoperative side effect among participants. Conclusion: Preoperative ICNB anesthesia for TT insertion is advised because of its capability to reduce whether postoperative pain or need for opioid injection that both potentially are associated with respiratory depression. Highlights: TT insertion considered painful which its following respiratory depression is potentially hazardous. ICNB is the preferred anesthetic method for TT insertion in compare with LA with bupivacaine. ICNB controls pain better whether during or through primary hours after TT insertion. Needing to opioid administration to ease ventilation after TT insertion is significantly low following ICNB.