Comparative evaluation of effects of intrapleural block with adjuvants on analgesia and pulmonary function after intercostal drainage: A pilot study
Journal Title: Medical Journal Armed Forces - Year 2019, Vol 75, Issue 2
Abstract
Background: Inter-costal chest drain (ICD) used for varied thoracic pathologies causes continuous pain and irritation of the pleura, which limits respiratory efforts and impairs ventilatory function. Intrapleural block deposits local anaesthetic between the layers of pleura and may improve ventilatory function especially in non surgical patients. Methods: Twenty eight ASA I-III patients treated with ICD, who could perform incentive spirometry, were included for study. They were randomized to 'Group C' (control group); 'Group B' (Bupivacaine); 'Group M' (Bupivacaine + Morphine) and 'Group D' (Bupivacaine + Dexmedetomidine). The drugs were administered via the ICD itself and clamped thereafter for 15 min. The success of the block was assessed by time for first analgesic demand, maximum inspiratory volume generated and Numerical Rating Scale score for pain; by patients. Results: Effective analgesia was observed in Group B, M and D. Addition of an adjuvant significantly prolonged time for rescue analgesic demand. Patients who received local anaesthetic alone or with an adjuvant had significantly improved maximal inspiratory volume and required lesser rescue analgesics. No significant complications were observed in any group. Pain relief in post-surgical patients using intraplural block is masked by systemic analgesics. However its application in patients with ICD for non surgical indications was explored in this study and was found to improve patient comfort and ventilation. Conclusion: Intra-pleural blockade is safe and effective in relieving the constant pleural irritation and pain of ICD, thus enabling the patient to improve ventilatory effort and faster recovery of respiratory function.
Authors and Affiliations
R. N. Verma
Keywords
Related Articles
- EP ID EP672316
- DOI 10.1016/j.mjafi.2018.03.004
- Views 56
- Downloads 0
Risk factors for degenerative aortic valve disease in India: A case control study
Background: Degenerative aortic valve disease often co-exists with coronary artery disease (CAD) and studies done in western populations have shown that it shares the same risk factors which cause CAD. However little is...
A randomized control trial to assess efficacy of Mifepristone in medical management of uterine fibroid
Background: Fibroids are the most common benign tumours of uterus. Heavy menstrual bleeding is the commonest concern for which medical attention is sought. Hysterectomies for leiomyoma constitute a third of all hysterect...
Is 400 IU per day of Vitamin-D given to healthy well-nourished mothers antenatally enough to prevent neonatal Vitamin-D deficiency?
Background: The incidence of Vitamin D deficiency (VDD) among newborns is very high in India, this is usually secondary to maternal deficiency. Currently Vitamin D at the dose of 400–600 IU/day is being prescribed during...
E-Licensing of Radiation Applications (eLORA) in Armed Forces Hospitals: 'Nuts and Bolts'
As per current statutory requirement, licence for operation of all medical radiation facilities (diagnostic radiology/radiotherapy/nuclear medicine) in India has to be obtained using the e-Licensing of Radiation Applicat...
The Currarino Triad
Currarino triad (syndrome) is an extremely rare condition, with an incidence of approximately 1 in 100,000,1 and only about 300 cases reported worldwide so far.2 It is a type of caudal regression syndrome in association...