Comparison of Intercostal Nerve Cryoanalgesia and Patient-controlled Analgesia for Early Post-thoracotomy Pain Control

  Objective  To compare the effectiveness of three new analgesia methods for early post-thoracotomy pain control.

  Methods  Totally 81 patients randomly accepted one of three new methods for post-thoracotomy analgesia: patient controlled intravenous analgesia(PCIA), patient controlled epidural analgesia(PCEA), and intercostal nerve cryoanalgesia(INC). The effects were evaluated by visual analogue scales(VAS)from the day of thoracotomy to 3 days after operation.

  Results  The dosage was not significantly different between PCEA and PCIA groups(P>0.05), but PCEA group had significantly less administration frequency(P < 0.05). The VAS score was significantly superior in PCEA group than in the other two groups(P < 0.01). The expectoration ability was significantly better in PCEA group than in INC groups(P < 0.01), and was significantly better in PCIA group than in INC group(P < 0.05)in the second and the third post-thoracotomy days. The incidence of side effects was significantly higher in PCIA group than in PCEA and INC groups(P < 0.01), and was significantly lower in INC group than in the other two groups(P < 0.01). The integrated evaluations showed that PCEA group was significantly better than the other two groups(P < 0.01).

  Conclusions  PCEA has better analgesic effect than PCIA and INC for post-thoracotomy pain control, lower incidence of side effects, and better expectoration ability. Thus, PCEA is the most suitable method for controlling the early post-thoracotomy pain.