J Korean Pain Soc.  1989 Nov;2(2):167-173.

Analgesic Effects of Intrapleural Bupivacaine Administration in Cholecystectomy Patients

• Koo GH

Abstract

Inadequate pain relief after upper abdominal surgery increases the incidence of pulmonary complications due to the difficulty in coughing and deep breathing. Kvalheim and Reiestad (1984)" introduced intrapleural administration of local anesthetic solutions to produce analgesia following cholecystectomy performed through a subcostal incision, unilateral breast surgery and renal surgery. We studied continuous intrapleural administration of bupivacaine and epinephrine, and its effect in controlling pain after cholecystectomy. In 9 patients, an intermittent dosage technique was used. An intrapleural catheter was inserted and 20 ml of 0.5% bupivacaine and 1:100,000 epinephrine was administered. Results were as following: 1) Mean analgesic duration from the initial intrapleural injection to secondary administration of supplementary bupivacaine was 13.5 hours. 2) No specific changes were noted on vital signs and arterial blood gases. 3) Effective analgesia, produced by intrapleural bupivacaine resulted in significant improvement in tidal volume as measured by spirometry. 4) No signs of systemic toxicity and complications were encountered. 5) lntrapleural administration of a local anesthetics after cholecystectomy provides a satisfactory duration of analgesia.

MeSH Terms

Analgesia
Anesthetics, Local
Breast
Bupivacaine*
Catheters
Cholecystectomy*
Cough
Epinephrine
Gases
Humans
Incidence
Respiration
Spirometry
Tidal Volume
Vital Signs
Anesthetics, Local
Bupivacaine
Epinephrine
Gases