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Ann Thorac Surg 1991;51:387-389
© 1991 The Society of Thoracic Surgeons

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Articles

Site of action of continuous extrapleural intercostal nerve block

Department of Thoracic Surgery, Bradford Royal Infirmary, Bradford, England

Accepted for publication October 17, 1990.

^_* Address reprint requests to Mr Sabanathan, Department of Thoracic Surgery, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, England.

Continuous extrapleural intercostal nerve block has been shown in a randomized, controlled study to be effective in reducing postoperative pain after thoracotomy and in restoring pulmonary mechanics. To assess the extent of spread of bupivacaine infused through an extrapleurally placed cannula inserted at thoracotomy, iohexol (Omnipaque) was infused at 5 days postoperatively in 5 patients and computed tomography performed. The contrast medium was confined to the paravertebral space covering on average six intercostal spaces. This study demonstrated that anatomically, the site of action of the bupivacaine infused through an extrapleural cannula was primarily in the paravertebral space.

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