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J Thorac Cardiovasc Surg 2009;137:e48-e49
© 2009 The American Association for Thoracic Surgery

Brief Communication

A new technique for continuous intercostal-intrapleural analgesia in videothoracoscopic surgery

Cattedra di Chirurgia Toracica, Policlinico Università Tor Vergata, Rome, Italy

Received for publication January 12, 2008; accepted for publication March 2, 2008.

^_* Address for reprints: Eugenio Pompeo, MD, Cattedra di Chirurgia Toracica, Policlinico Università Tor Vergata, V.le Oxford, 81, 00133 Rome, Italy. (Email: pompeo@med.uniroma2.it).

The first 20% of the full text of this article appears below.

Videothoracoscopic surgery has reduced the invasiveness of a considerable number of thoracic operations, although optimal postoperative thoracic analgesia remains an open issue.¹ Among commonly used methods, continuous intravenous infusion of analgesics, including opioids and nonsteroidal anti-inflammatory drugs, has shown promise but is not always satisfactory and can have some adverse effects.² We developed a new technique of continuous intercostal-intrapleural analgesia (CIIA) in videothoracoscopic lung resections, which is based on a double-catheter pain relief system (On-Q Pain Buster; I-Flow Corp, Lake Forest, Calif) to provide continuous infusion of ropivacaine (Figure 1, A ).

View larger version (75K):   Figure 1. Schematic illustration of the CIIA method showing the elastomeric pump (EP), the intercostal catheter (ICC), and the second elastomeric pump catheter, connected to a double-lumen chest tube for high intrapleural release (IPR) of ropivacaine (A). Intraoperative thoracoscopic vision during transthoracic subpleural insertion of the intercostal catheter (ICC, black arrow) (B).

At the end of the operation, under thoracoscopic vision, we place the first catheter just below the parietal pleura and along the vascular-nervous intercostal bundle, which crosses the passage of the chest . . . [Full Text of this Article]

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