Pain Control of Thoracoscopic Major Pulmonary Resection

Pain Control of Thoracoscopic Major Pulmonary Resection: Is Pre-emptive Local Bupivacaine Injection Able to Replace the Intravenous Patient Controlled Analgesia?

The purpose of this study is to evaluate whether pre-emptive local bupivacaine injection is a better alternative pain control modality than the conventional intravenous patient controlled analgesia.

Despite less postoperative pain from Video Assisted Thoracic Surgery (VATS) than thoracotomy, pain is still an important issue in its recovery period. After VATS procedure, intravenous patient controlled analgesia (IV PCA) is being used for pain control. However, the side effects of IV PCA are nausea, vomiting, sleepiness, and urination difficulty which interrupt the early recovery. It is established that pre-emptive local bupivacaine injection is more economical, has almost no side effects, and finally, it is effective for the postoperative 24 hours. The purpose of this study is to evaluate whether pre-emptive local bupivacaine injection is a better alternative pain control modality than the conventional intravenous patient controlled analgesia.

Inclusion Criteria:

• patients that are expected to receive VATS segmenectomy or lobectomy regardless of disease entity

Exclusion Criteria:

• not done by VATS anatomical resection
• patient does not agree to the study
• postoperative hospital stay exceeds 7 days due to postoperative complications
• existence of preoperative renal insufficiency (Cr > 1.5)
• OT/PT > 120
• history of Lidocaine hypersensitivity