Interpleural Administration of Bupivacaine for Chest Pain after Transthoracic Endoscopic Sympathectomy Operation for Palmar Hyperhidrosis Patients

手掌多汗症病患接受經胸腔內視鏡交感神經切斷術後的肋膜疼痛控制方法

趙榮勤(Rockey Chao) ； 劉敏英(Ming-Ying Liu) ； 黃協周(Shye-Jou Hwang) ； 蘇泉發(Chain-Fa Su) ； 林欣榮(Shinn-Zong Lin) ； 宋文鑫(Wen-Shin Song)

《Journal of Medical Sciences》 15卷1期 (1994/08) Pp. 65-72

摘要

三軍總醫院從1991年5月至1992年9月，利用內視鏡法成功的治癒665個手掌多汗症的病人。這些病人手術後有輕微到嚴重的胸痛情形，為了減輕疼痛我們評估了22個病人用0.5% Bupivacaine 20c.c.在手術後單側肋膜麻醉方式以目視疼痛評分表(Visual analogue scale)來分析，可以發現肋膜麻醉側之胸痛明顯低於未實施肋膜麻醉側之胸痛。因而我們認為肋膜麻醉止痛可以很好的控制手術後胸口的疼痛。

關鍵字

肋膜麻醉 ； 內視鏡交感神經切除 ； 目視疼痛評分表

並列摘要

We have treated 665 patients with palmar hyperhidrosis under endoscopy technique at the Tri-Service General Hospital from May. 1991 to Sep. 1992. In 1330 sides of operation, we have done 1304 sides successfully. Patients have mild to severe degree of chest pain variablely after operation. For relief of the uncomfortable chest pain, we chosed 22 patients and compared their visual analogue scale (V.A.S.) after randomly unilateral interpleural administration of 0.5% Bupivacaine 20 ml with double blind method. There are 4 patients with chest pain in not treated side V.A.S. (0-100 mm) less than 20 mm. It revealed no significant difference of both chest pain after one side interpleural administration of Bupivacaine solution. There are 18 patients with chest pain in not treated side V.A.S. greater than 21 mm. It showed significant pain relief over the interpleural administration side of chest. We considered the interpleural analgesia can successfully provide endoscopic sympathectomy patients with good pain control after operation.

並列關鍵字

Interpleural analgesia ； endoscopic sympathectomy ； visual analogue scale ； bupivacaine