Shrestha B R, Tabadar S, Maharjan S, Amatya S R
Department of Anaesthesia, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
Kathmandu Univ Med J (KUMJ). 2003 Jan-Mar;1(1):46-7.
Management of pain in surgical patient is very crucial. It is more so in thoracic and upper abdominal surgery. Lots of technique and drugs have been used to control postoperative pain including thoracic epidural analgesia. We describe a case in whom Intraoperative and Postoperative pain was managed by injecting 0.5% bupivacaine 20 ml in the interpleural space through the catheter, followed by continuous infusion of 0.1% bupivacaine 10 ml/ hour for 24 hours. The whole perioperative and postoperative period was uneventful. The first series of patients in whom this technique was used was described by Murphy in 1983, (1) who used it in patients with multiple fractured ribs and in postoperative patients after gallbladder and kidney surgery. One year later, Reiestad and Kvalheim published their results of continuous intercostal nerve block for postoperative pain relief and presented their modification of the technique, which is now termed interpleural analgesia.
外科患者疼痛的管理至关重要。在胸外科和上腹部手术中更是如此。许多技术和药物已被用于控制术后疼痛，包括胸段硬膜外镇痛。我们描述了一例患者，术中及术后通过导管在胸膜间隙注射20 ml 0.5%布比卡因，随后持续输注0.1%布比卡因10 ml/小时，持续24小时来控制疼痛。整个围手术期和术后过程均顺利。1983年，墨菲描述了首批使用该技术的患者，（1）他将其用于多根肋骨骨折患者以及胆囊和肾脏手术后的患者。一年后，赖斯塔德和克瓦尔海姆发表了他们连续肋间神经阻滞用于术后镇痛的结果，并介绍了他们对该技术的改进，即现在所称的胸膜间镇痛。
