Objective: To study the efficacy of bilateral intercostal nerve protection on pain relief after thoracotomy.
Methods: Sixty patients in need of thoracotomy were randomized into 3 groups: Group C (control group, undergoing standard posterolateral thoracotomy, n = 18), Group U (unilateral intercostal nerve protection group, undergoing protection of intercostal nerve above the incision based on the standard posterolateral thoracotomy, n = 20), and Group B (bilateral intercostal nerve protection group, undergoing protection of intercostal nerves above and below the incision based on the standard posterolateral thoracotomy, n = 22). Numeric rating scale (NRS) was adopted to document the severity of pain at different time points after surgery. The amount of analgesic use was recorded as well.
Results: The pain scores recorded on the postoperative days 2 to 7 and 1 month after surgery of Group B were all significantly lower than those of Group C (all P < 0.05). Significant pain relief was observed in Group U within the 7 postoperative days compared with Group C; however, there were not significant differences in pain scores among different groups 1 month after surgery. Pain relief after the removal of chest tubes was found only in Group B (P = 0.020). The incidence of morbidity was similar among the 3 groups.
Conclusion: Protection of bilateral intercostal nerves around the incision contributes to significant pain relief after operation without increase of the morbidity of complications.