OPEN INTRAOPERATIVE RETROPLEURAL PERINEURAL INJECTION OF BUPIVACAINE FOR POST OPERATIVE PAIN MANAGEMENT IN THORACIC SURGERY
Dr. P. A. Kamble, Dr. Mayuri Kamble, Dr. A. T. Kamble, *Dr. Aditya Mehta and Dr. Bindesh Dube
Total 27 cases of pulmonary and pleural pathology were selected and were subjected to surgery by open
thoracotomy method, which requires greater exposure for approach to the pathology. It is therefore achieved by a
large incision on the thorax maybe by intercostal approach or by rib resection. A drug was selected and after the
completion of the procedure was injected retropleurally perineurally, along the site of the incision taking care not to
inject in the blood vessel. After completion of the surgery, injection bupivacaine was administered as per the
procedure laid down and the patient was assessed for the effect of the analgesia. After surgery, patient was shifted
to the intensive care unit for pain management and it is observed that the patient has complete analgesia and
promotes deep respiration and limits the blood loss and the air entry improved. Follow up was done by a
continuous monitoring for pain. The patient was shifted to the ward after all the parameters stabilised. So,
bupivacaine is a drug which requires a smaller dose and delivers maximum effect. Patient was discharged on the
tenth day depending upon their recovery without any functional incapacitation.
Keywords: Bupivacaine, Perineural injection, Thoracotomy.
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