Alcoholization of the Intercostal Nerves on the Postoperative Period of Thoracic Surgery

Abstract

Introduction: Thoracic surgery is among the most painful surgical procedures.

Objective: To describe the outcomes of the alcoholization of the intercostal nerves for postoperative analgesia.

Methods: A prospective, observational and descriptive study was carried out, with patients treated surgically for thoracic conditions during 2018-2019. The sample included fifty patients who met the inclusion criteria: operated by the corresponding author, older than eighteen years, intercostal access and patients who signed the informed consent. Those operated on by other surgeons or who had chest wall involvement were excluded. Pain intensity was categorized into four groups: mild, moderate, intense and unbearable, according to the analog-visual scale.

Results: During the first night, mild (25: 50%) and moderate (9: 18%) pain predominated. Severe pain occurred in two (4%) patients, while 14 (28%) did not require any additional medication. The next day, there were no cases of severe pain and only nine reported moderate pain. Epidural analgesia was only used the first night and the next day. The tendency to decrease in pain was maintained on the second and third days. There were no cases with unbearable pain. In the long term, only one patient had severe pain and required, therefore, treatment with blocks.

Conclusions: Alcoholization decreased the additional use of analgesics. There were no complications or unbearable pain, a reason why we consider that this method could be a safe alternative, especially when expensive drugs or personnel trained in modern postoperative analgesia techniques are not available.

Keywords: thoracic surgery; alcoholization; intercostal nerves; pain.