Effect of bilateral intercostal nerve protection on post-thoracotomy pain relief: a prospective single-blinded randomized study

Abstract

To study the efficacy of bilateral intercostal nerve protection on pain relief after thoracotomy. Sixty patients in need of thoracotomy were randomized into 3 groups: Group C (control group, undergoing standard posterolateral thoracotomy, n = 18), Group U (unilateral intercostal nerve protection group, undergoing protection of intercostal nerve above the incision based on the standard posterolateral thoracotomy, n = 20), and Group B (bilateral intercostal nerve protection group, undergoing protection of intercostal nerves above and below the incision based on the standard posterolateral thoracotomy, n = 22). Numeric rating scale (NRS) was adopted to document the severity of pain at different time points after surgery. The amount of analgesic use was recorded as well. The pain scores recorded on the postoperative days 2 to 7 and 1 month after surgery of Group B were all significantly lower than those of Group C (all P < 0.05). Significant pain relief was observed in Group U within the 7 postoperative days compared with Group C; however, there were not significant differences in pain scores among different groups 1 month after surgery. Pain relief after the removal of chest tubes was found only in Group B (P = 0.020). The incidence of morbidity was similar among the 3 groups. Protection of bilateral intercostal nerves around the incision contributes to significant pain relief after operation without increase of the morbidity of complications.