Fleming W H, Sarafian L B
J Thorac Cardiovasc Surg. 1977 Aug;74(2):273-4.
Postoperative pain is an important factor in the management of children undergoing thoracotomy. Intercostal nerve block has been used in adult patients, but its applicability in the pediatric age group has not been previously evaluated. Eighty-nine children (85 girls and 31 boys) aged 6 months to 16 years (mean age 4.7 years) underwent ligation of a patent ductus arteriosus (PDA) through a left thoracotomy. Twenty-nine children received intercostal blocks with bupivacaine from the level of the second to sixth thoracic vertebrae. Sixty cases constituted the control group. The patients with intercostal block had fewer doses of pain medication postoperatively, 2.7 mean (0 to 9), than did the control patients, 3.9 mean (0 to 21). The mean hospital stay was shortened in the patients with nerve block, 5.1 days versus 7.3 days for the control group. No ill effects of bupivacaine were noted. We conclude that intercostal nerve block is a valuable procedure reducing the need for postoperative analgesia and shortening hospital stay.
术后疼痛是小儿开胸手术管理中的一个重要因素。肋间神经阻滞已应用于成年患者，但此前尚未评估其在儿童年龄组中的适用性。89名年龄在6个月至16岁（平均年龄4.7岁）的儿童（85名女孩和31名男孩）通过左胸切口接受动脉导管未闭（PDA）结扎术。29名儿童接受了从第二至第六胸椎水平的布比卡因肋间阻滞。60例为对照组。接受肋间阻滞的患者术后使用止痛药物的剂量较少，平均为2.7次（0至9次），而对照组患者平均为3.9次（0至21次）。神经阻滞患者的平均住院时间缩短，为5.1天，而对照组为7.3天。未观察到布比卡因的不良影响。我们得出结论，肋间神经阻滞是一种有价值的方法，可减少术后镇痛需求并缩短住院时间。
