Interpleural Anesthesia

Abstract

In 1986, Reiestad and Strömskag introduced interpleural postoperative analgesia with local anaesthetic solutions. The aim of this review was to describe the physiological mechanisms, indications and limits of this new mechanisms, indications and limits of this new technic. Interpleural analgesia has been successfully used for pain relief after cholecystectomy by subcostal incision. Nevertheless, the potential side-effects of this technic and the reduction of the postoperative pain with the use of coelioscopic approach discard interpleural analgesia. After thoracotomy, if this technic seemed to be simple by visual placement of the catheter tips by the surgeon, most of the studies failed to demonstrate reduction of postoperative pain. Finally, interpleural analgesia has recently been shown to be effective in the management in various chronic pain syndromes of the upper abdomen (pancreatitis...) and thorax (postherpetic neuralgia, upper extremity reflex sympathetic dystrophy). The efficacy of this technic for long-term chronic pain involves the blockade of the sympathetic chain of the injected side.