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Ipsilateral shoulder pain after thoracotomy is common and may be severe, even in the presence of a functioning thoracic epidural. We have shown that infiltration of the phrenic nerve with local anesthetic significantly and safely reduces this shoulder pain, potentially allowing the ideal goal of a pain-free thoracotomy.

Intrapleural administration of 40 ml of bupivacaine 0.25% does not provide effective pain relief for ipsilateral post-thoracotomy shoulder pain.

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