Engdahl O, Boe J, Sandstedt S
Department of Anesthesiology, Central Hospital, Växjö, Sweden.
Acta Anaesthesiol Scand. 1993 Feb;37(2):149-53. doi: 10.1111/j.1399-6576.1993.tb03691.x.
The ability of interpleural analgesia to reduce the pain caused by an indwelling chest drain was evaluated in 22 patients treated for spontaneous pneumothorax. Intermittent 8-hourly bolus injections of 20 ml bupivacaine 0.5% with epinephrine were compared with placebo in a randomized double-blind fashion. Visual analogue pain scale (VAS) scores were registered after the 1st, 2nd, 4th, 7th and 10th injections. The scores were significantly lower in the bupivacaine group at 5, 15, 30 and 60 min after the first injection. No significant differences in pain scores were found after 4 or 8 h. Pain scores in the bupivacaine group were also reduced after the 2nd, 4th, 7th and 10th injections, but compared with placebo the differences were significant only after the 2nd and 7th injections. Parenteral morphine consumption was not significantly lower in the bupivacaine group. Arterial blood gases were unaffected by the treatment in both groups. It is concluded that interpleural analgesia using bupivacaine given as bolus injections at 8-h intervals significantly reduces the pain caused by a chest drain within 5 min of injection, but the duration of pain relief is less than 4 h.
在22例因自发性气胸接受治疗的患者中，评估了肋间神经阻滞镇痛减轻留置胸腔引流管所致疼痛的能力。采用随机双盲方式，将每8小时一次、每次20 ml的0.5%布比卡因加肾上腺素间歇推注与安慰剂进行比较。在第1、2、4、7和10次注射后记录视觉模拟疼痛量表（VAS）评分。首次注射后5、15、30和60分钟，布比卡因组的评分显著较低。4或8小时后，疼痛评分无显著差异。第2、4、7和10次注射后，布比卡因组的疼痛评分也有所降低，但与安慰剂相比，仅在第2次和第7次注射后差异显著。布比卡因组的胃肠外吗啡消耗量无显著降低。两组的动脉血气均未受治疗影响。得出的结论是，每8小时一次推注布比卡因进行肋间神经阻滞镇痛可在注射后5分钟内显著减轻胸腔引流管所致疼痛，但疼痛缓解持续时间不足4小时。
