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Ann Thorac Surg 2003;76:978
© 2003 The Society of Thoracic Surgeons

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Correspondence

Reply

^a Department of Surgery,Kurume University School of Medicine,67 Asahi-machi,Kurume 830-0011, Japan

e-mail: stakam{at}med.kurume-u.ac.jp

To the Editor:

We thank Drs Richardson and Anikin for their comments on our report of intraoperative intercostal nerve blockade for postthoracotomy pain [1].

In the study, the anesthesiologist confirmed correct placement of the epidural catheter before thoracotomy, but did not give a local anesthetic bolus. Our rather high pain scores may reflect inadequate pain relief. Therefore, the aim of our study was whether the additional intercostal nerve blockade provided an additive benefit for pain relief.

The dermatomal coverage for thoracotomy was described as blocking up to seven dermatomes [2]. An antero-axillary incision in the study was between 15 and 25 cm in width. We performed four intercostal nerve blocks focusing on pain relief but not on dermatomic coverage.

Although we have no experience with paravertebral nerve blocks, their experience was excellent [3]. The method of paravertebral analgesia is an attractive alternative to epidural analgesia. We need a study comparing the two methods of analgesia where each technique is individually optimized.

References

1. Takamori S., Yoshida S., Hayashi A., Matsuo T., Mitsuoka M., Shirouzu K. Intraoperative intercostal nerve blockade for postthoracotomy pain. Ann Thorac Surg 2002;74:338-341.[Abstract/Free Full Text]
2. Conacher I.D. Pain relief after thoracotomy. Br J Anaesth 1990;65:806-812.[Free Full Text]
3. Richardson J., Sabanathan S., Jones J., Shah R.D., Cheema S., Mearns A.J. A prospective randomized comparison of preoperative and balanced epidural or paravertebral bupivacaine on thoracotomy pain, pulmonary function and stress responses. Br J Anaesth 1999;83:378-392.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Takamori, S. Search for Related Content PubMed Articles by Takamori, S. Related Collections Chest wall