Intrapleural analgesia following thoracoscopic sympathectomy for palmar hyperhidrosis

Assalia, Ahmad; Kopelman, Doron; Markovits, Robert; Hashmonai, M

doi:10.1007/s00464-002-8733-x

Cited by 19 publications

(20 citation statements)

References 13 publications

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“…Assalia et al 9 studied 50 patients submitted to thoracic sympathectomy by using 20mL of 0.5% intrapleural bupivacaine bilaterally with reduction in the pain score and in opioid consumption. A similar result was observed by Lieou et al 13 in the first 6 hours after thoracic sympathectomy in 60 patients to whom 10mL of 0.5% intrapleural bupivacaine was administrated bilaterally.…”

Section: Resultsmentioning

confidence: 99%

“…Once a local anesthetic is injected into the pleural cavity, it makes direct contact with the exposed tissue, thus enabling long-lasting analgesia without risk for pneumothorax or intravascular anesthetic injection 9 . This technique, which is referred to as intrapleural block, was firstly published in 1986 10,11 using bupivacaine as a local anesthetic for surgeries on the upper abdominal surgeries 12 , and it has also been recently used in thoracic sympathectomy 9,13 .…”

Section: Introductionmentioning

confidence: 99%

“…This technique, which is referred to as intrapleural block, was firstly published in 1986 10,11 using bupivacaine as a local anesthetic for surgeries on the upper abdominal surgeries 12 , and it has also been recently used in thoracic sympathectomy 9,13 . However, central nervous system toxicity was observed when bupivacaine was used in patients with pleural inflammation due to recent pneumonia, thus showing greater anesthetic absorption by injured tissue…”

Section: Introductionmentioning

confidence: 99%

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Intrapleural analgesia after endoscopic thoracic sympathectomy

et al. 2011

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Brazil. Advisor and critical revision. ABSTRACT PURPOSE:To compare analgesia traditionally used for thoracic sympathectomy to intrapleural ropivacaine injection in two different doses. METHODS: Twenty-four patients were divided into three similar groups, and all of them received intravenous dipyrone. Group A received intravenous tramadol and intrapleural injection of saline solution. Group B received intrapleural injection of 0.33% ropivacaine, and Group C 0.5% ropivacaine. The following aspects were analyzed: inspiratory capacity, respiratory rate and pain. Pain was evaluated in the immediate postoperative period by means of the visual analog scale and over a one-week period. RESULTS: In Groups A and B, reduced inspiratory capacity was observed in the postoperative period. In the first postoperative 12 hours, only 12.5% of the patients in Groups B and C showed intense pain as compared to 25% in Group A. In the subsequent week, only one patient in Group A showed mild pain while the remainder reported intense pain. In Group B, half of the patients showed intense pain, and in Group C, only one presented intense pain. CONCLUSION: Intrapleural analgesia with ropivacaine resulted in less pain in the late postoperative period with better analgesic outcomes in higher doses, providing a better ventilatory pattern. Keywords: Intrapleural Analgesia. Sympathectomy. Thoracoscopy. RESUMO OBJETIVO:Comparar a analgesia tradicionalmente utilizada para simpatectomia videotoracoscópica à injeção intrapleural de ropivacaína em duas doses diferentes. MÉTODOS: Vinte e quatro pacientes foram distribuídos em três grupos semelhantes, e todos eles receberam dipirona endovenosa. O grupo A recebeu tramadol endovenoso e injeção intrapleural de solução salina. O grupo B recebeu injeção intrapleural de ropivacaína a 0,33%, e Grupo C ropivacaína a 0,5%. Os aspectos analisados foram: capacidade inspiratória, freqüência respiratória e dor. A dor foi avaliada no período pós-operatório por meio da escala visual analógica e durante o período de uma semana. RESULTADOS: Nos grupos A e B, a redução da capacidade inspiratória foi observada no período pós-operatório. Nas primeiras 12 horas de pós-operatório, apenas 12,5% dos pacientes nos grupos B e C apresentaram dor intensa em comparação a 25% no Grupo A. Na semana seguinte, apenas um paciente do grupo A apresentou dor leve, enquanto o restante relatou dor intensa. No Grupo B, metade dos pacientes apresentou dor intensa, e no Grupo C, apenas um apresentou intensa dor. CONCLUSÃO: A analgesia intrapleural com ropivacaína resultou em menos dor no pós-operatório tardio com os melhores resultados analgésicos nas doses mais altas, proporcionando um melhor padrão ventilatório. Descritores: Analgesia Intrapleural. Simpatectomia. Toracoscopia. Intrapleural analgesia after endoscopic thoracic sympathectomyActa Cirúrgica Brasileira -Vol. 26 (6) 5011 -509

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intrapleural analgesia after endoscopic thoracic sympathectomy

et al. 2011

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“…Dolor pleurítico persistente e intenso suele seguir a extensa lisis de adhesiones pleurales o a aparición de neumotórax persistente, efusión pleural o empiema 4,7,47 . Para su tratamiento pueden usarse analgésicos sistémicos (morfina, paracetamol, antiinflamatorios no esteroideos, etc.)…”

Section: Dolor Postoperatoriounclassified

“…y anestésicos locales introducidos en cavidad torácica a través de un tubo torácico. Así, el uso de anestesia intrapleural bilateral mediante la colocación en la cavidad torácica de 10-20 ml de bupicaína al 0.5% y 5 mg/ml de adrenalina al final de la simpatectomía, consigue una reducción significativa del dolor y del uso de analgésicos 4 . Otra medida que puede reducir significativamente el dolor postoperatorio y el requerimiento de analgésicos es el bloqueo de los nervios intercostales internos con 3 ml de bupicaína al 0.5% en cada uno de los niveles intercostales T2, T3 y T4 7,47 .…”

Section: Dolor Postoperatoriounclassified