Efficacy of ketorolac tromethamine and extrapleural intercostal nerve block on post-thoracotomy pain. A prospective, randomized study

A. Carretta, P. Zannini, G. Chiesa, R. Altese, G. Melloni, A. Grossi

Research output: Contribution to journalArticle

Abstract

Background. Post-thoracotomy pain causes severe impairment of the respiratory function. Epidural analgesia is effective in the treatment of post-thoracotomy pain but may give rise to significant side-effects. Other low-risk and cost-effective analgesic treatments are therefore required. Methods. Thirty male patients who had undergone pulmonary lobectomy entered a prospective, randomized trial to evaluate the efficacy of ketorolac tromethamine (Group 2) and extrapleural intercostal nerve block (Group 3) with intermittent low-dose bupivacaine. Objective and subjective assessment was carried out at 8, 16, 24 and 48 hours postoperatively. Results. There were no significant differences between Groups 1 (control group) and 2. Vital capacity was significantly lower in Group 3 (p <0.05) than in Group 1 after 16 hours. Forced Vital Capacity was significantly higher in Group 2 than-in Group 3 after 16 and 24 hours (p <0.05). Peak expiratory flow was also significantly better in Group 2 than in Group 3 after 16 hours (p <0.05). On-demand opioid consumption was significantly lower in Group 2 (p <0.001) and Group 3 (p <0.05). No side-effects were observed. Conclusions. Ketorolac tromethamine was effective in the treatment of post-thoracotomy pain. Extrapleural intercostal nerve block allowed a significant reduction in the consumption of opioids. These analgesic techniques could be useful as low-risk, cost-effective and reproducible treatments when more effective techniques, such as epidural analgesia, are contraindicated.

Original languageEnglish
Pages (from-to)224-228
Number of pages5
JournalInternational Surgery
Volume81
Issue number3
Publication statusPublished - 1996

Keywords

  • Analgesia
  • Pain, postoperative
  • Thoracotomy

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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    Carretta, A., Zannini, P., Chiesa, G., Altese, R., Melloni, G., & Grossi, A. (1996). Efficacy of ketorolac tromethamine and extrapleural intercostal nerve block on post-thoracotomy pain. A prospective, randomized study. International Surgery, 81(3), 224-228.