Vieira Antonio Mauro, Schnaider Taylor Brandão, Brandão Antonio Carlos Aguiar, Campos Neto João Pires
Departamento de Farmacologia, Universidade do Vale do Sapucaí, Brazil.
Rev Bras Anestesiol. 2003 Jun;53(3):346-50.
Postoperative analgesia is a wish of all surgical patients and has been used by most anesthesiologists. In addition to opioids, local anesthetic agents have been employed for peripheral and central blocks. The purpose of this study was to evaluate and to compare intercostal and interpleural blocks for post-cholecystectomy analgesia.
Sixty patients undergoing open cholecystectomy with subcostal incision, received either intercostal block (Group IC, n = 30) or interpleural block (Group IP, n = 30), for postoperative analgesia, both with 0.5% bupivacaine (100 mg) with epinephrine. Analgesia duration and patients complaints were evaluated.
Analgesia was considered satisfactory for both groups. Mean analgesia duration was 505 minutes for Group IP and 620 minutes for Group IC, with no statistical significant difference. Nausea, vomiting and mild abdominal pain were the most frequent postoperative complaints. There was no postoperative complication related to blockade and no pneumothorax was detected.
We concluded that both techniques were effective in promoting post-cholecystectomy analgesia, but interpleural block was easier to perform.
术后镇痛是所有外科手术患者的期望，并且大多数麻醉医生都采用术后镇痛。除阿片类药物外，局部麻醉药已用于外周和中枢神经阻滞。本研究的目的是评估和比较肋间阻滞与胸膜间阻滞用于胆囊切除术后镇痛的效果。
60例行肋缘下切口开腹胆囊切除术的患者，接受肋间阻滞（IC组，n = 30）或胸膜间阻滞（IP组，n = 30）以进行术后镇痛，均使用含肾上腺素的0.5%布比卡因（100 mg）。评估镇痛持续时间和患者的主诉。
两组的镇痛效果均被认为满意。IP组的平均镇痛持续时间为505分钟，IC组为620分钟，差异无统计学意义。恶心、呕吐和轻度腹痛是最常见的术后主诉。未发现与阻滞相关的术后并发症，也未检测到气胸。
我们得出结论，两种技术在促进胆囊切除术后镇痛方面均有效，但胸膜间阻滞更容易实施。
