Intercostal nerve blockade with alcohol during operation for postthoracotomy pain

OBJECTIVE Purpose of this study was to evaluate the effectiveness of intraoperative intercostal nerve blockade with alcohol in addition to epidural analgesia with morphine for control of postthoracotomy pain syndrome. MATERIAL AND METHODS 57 oncological patients undergoing antero-axillary thoracotomy were randomized to receive intraoperative intercostal nerve blockade with alcohol plus postoperative epidural analgesia with morphine (n=27) and postoperative epidural analgesia with morphine only (n=30). 31 patients had lobectomy, 10 bilobectomy, 9 pulmonectomy and 7 segmentectomy. There were 42 right sided and 15 left sided procedures. Objective and subjective assessment was carried out at 10 and 30 days postoperatively. Pain was assessed by using a subjective visual pain scale ranging from 1 (no pain) to 10 (worst pain) during coughing. RESULTS Postsurgical pain was significantly lower in intraoperative intercostal nerve blockade patients group. The mean pain score on the 10 postoperation day was 2.1 and 6.5 accordingly in intraoperative intercostal nerve blockade and epidural analgesia with morphine patients group. The mean pain score on the 30 day was accordingly 1.5 and 4.2. CONCLUSION Additional intraoperative intercostal nerve blockade with alcohol provides an additional benefit for postthoracotomy pain relief, especially for at least one month following the thoracotomy.