Epidural Infusion
- Thoracic epidural traditionally used with catheter placed in the midpoint of the dermatomal distribution of the skin incision
- Associated with comparable analgesia to paravertebral block postoperatively
- but significantly more hypotension and urinary retention
- May also reduce the effectiveness of coughing, especially in patients who already have a low FEV1
Paravertebral Infusion
- Increasingly popular option for postoperative analgesia
- Offers the advantage of producing unilateral analgesia and limiting sympathetic block
- Shown to be as effective as thoracic epidural in providing postoperative analgesia with fewer complications
- Can be performed preoperatively by the It can be done by the anaesthetist or under direct vision by the surgeon before closure
Intrapleural Infusion
- Produces a multi-level intercostal block
- However, analgesia is extremely dependent on patient position and infusion volume with significant volumes drained out if chest drains are in situ
- Not found to be reliable in clinical practice and rarely used on a routine basis
Epidural Infusion
- Thoracic epidural traditionally used with catheter placed in the midpoint of the dermatomal distribution of the skin incision
- Associated with comparable analgesia to paravertebral block postoperatively
- but significantly more hypotension and urinary retention
- May also reduce the effectiveness of coughing, especially in patients who already have a low FEV1
Paravertebral Infusion
- Increasingly popular option for postoperative analgesia
- Offers the advantage of producing unilateral analgesia and limiting sympathetic block
- Shown to be as effective as thoracic epidural in providing postoperative analgesia with fewer complications
- Can be performed preoperatively by the It can be done by the anaesthetist or under direct vision by the surgeon before closure
Intrapleural Infusion
- Produces a multi-level intercostal block
- However, analgesia is extremely dependent on patient position and infusion volume with significant volumes drained out if chest drains are in situ
- Not found to be reliable in clinical practice and rarely used on a routine basis