Abstract

A novel approach to the treatment of post-operative pain by the intermittent administration of local anesthetics into the pleural space through an interpleural catheter has been studied. The method has been used in 81 patients. Forty-two of the patients had undergone cholecystectomy with subcostal approach, 25 patients had renal surgery, while 14 patients had undergone unilateral breast operations. Effective and long-lasting pain relief was achieved with this technique alone in 78 cases. Duration of analgesia after a single 20 ml dose of bupivacaine 0.5% with epinephrine was 6-27 hours, with a mean time of 10 hours. Only three patients in the group were not satisfied with the degree of analgesia and required additional analgesia by administration of opiate analgesics. No complications pertaining to the technique were encountered. This new technique may have advantages over traditional opiate treatment, epidural analgesia with local anesthetics, and morphine in the epidural space. The interpleural technique seems highly effective and is technically relatively simple, while the risk of complication appears to be small.