Background: Pain due to coughing after thoracoscopic surgery remains a clinical problem, and its relief by intrapleural analgesia has not been extensively studied. This study attempts to determine the suitable volume of 0.75% ropivacaine needed for intrapleural analgesia after thoracoscopic surgery.
Methods: A double-blind, randomized, controlled trial was performed. Forty-five patients were randomly divided into three groups: R20, R15, and R10 (n = 15); 20 ml, 15 ml, or 10 ml of 0.75% ropivacaine was injected into the pleural cavity of each patient in the 3 groups, respectively, when the pain score from postoperative coughing was ≥4. The primary outcome was pain score upon coughing (C-NRS), and the secondary outcomes were pain score at rest (R-NRS), morphine consumption, time of onset, and duration of intrapleural analgesia.
Results: All patients in the R20 and R15 groups reported effective pain relief after intrapleural injection when postoperative coughing occurred. However, only 7 patients in the R10 group reported effective relief of pain. Compared with the patients in the R10 group, patients in the R20 and R15 groups had lower C-NRS scores, less morphine consumption at 8 h and 24 h, a shorter time to pain relief, and a longer duration of analgesia. There was no significant difference of R-NRS among the three groups.
Conclusion: Intrapleural analgesia with 0.75% ropivacaine at a volume of 15 ml or 20 ml effectively relieved pain due to coughing after thoracoscopic surgery.
Trial registration: ChiCTR1800017515.
Keywords: Coughing-pain; Dosage; Intrapleural analgesia; Ropivacaine.
Copyright © 2019. Published by Elsevier Ltd.