• Yoshihiro Ishikawa, Takamitsu Maehara, Teppei Nishii, Kazuki Yamanaka, Hiroyuki Adachi, Shizu Saito, and Munetaka Masuda.
• Department of Thoracic Surgery, National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. yokkun.ishikawa@w3.dion.ne.jp
• Ann Thorac Cardiovasc Surg. 2012 Jan 1; 18 (5): 429-33.

Purposeto evaluate the efficacy and safety of intrapleural analgesia (IPA) using ropivacaine after thoracoscopic surgery, compared with thoracic epidural analgesia (TEA) using ropivacaine.Methodsforty patients undergoing thoracoscopic bullectomy for spontaneous pneumothorax were randomly assigned to one of two groups. IPA group (n = 20) received intermittent bolus injection of 0.375% ropivacaine into intrapleural space two times; at the end of operation and one more time as the pain increased. TEA group (n = 20) received continuous epidural analgesia with 0.375% ropivacaine. Transrectal diclofenac was administered as an additional analgesic. Pain was assessed on the basis of additional analgesics requirements and by using a visual analog scale (VAS).Resultsthe time courses of VAS scores along the postoperative time course were not significantly different (p = 0.175). Consumption of transrectal diclofenac was significantly smaller in IPA group (p = 0.025). No major complications appeared in both groups, and incidence of adverse symptoms was not different.Conclusionsin IPA group, pain was managed with less consumption of additional analgesics. IPA could be one of the good choices after thoracoscopic surgery for its efficacy, safety, and benefit of easy placement of the catheter.

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