Pain relief

In the past there has been great emphasis in avoiding respiratory depression due to opiate administration. This has led to atelectasis and retained secretions in patients who develop shallow respiration. The best method of pain relief in a conscious breathing patient is well-supervised epidural anesthesia. This system is not always available, and supervision and technical skills are often inadequate in some locations where lung resection is carried out. An alternative system without the risks of epidural anesthesia is the insertion of a catheter between the chest wall and the pleura. In addition, an infusion of bupivacaine can be delivered to the intercostal nerves on the operated side (Carabine etaj 1995).

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