Effect of bilateralintercostal nerve protection on post-thoracotomy pain relief: a prospective single-blindedrandomized study

：Objective To study theefficacy of bilateral intercostal nerve protection on pain relief afterthoracotomy.Methods Sixty patients in need of thoracotomy were.randomized into 3groups:Group C(control group,undergoing standard posterolateral thoracotomy,n=18),GroupU(unilateral intercostal nerve protection group,undergoing protection of intercostal nerveabove the incision based on the standard posterolateral thoracotomy,n=20),and GroupB(bilateral intercostal nerve protection group,undergoing protection of intercostal nervesabove and below the incision based on the standard posterolateralthoracotomy,n=22).Numeric rating scale(NRS)was adopted to document the severity of pain atdifferent time points after surgery.The amount of analgesic use was recorded aswell.Results The pain scores recorded on the postoperative days 2 to 7 and 1 month aftersurgery of Group B were all significantly lower than those of Group C(all P＜0.05).Significant pain relief wasobserved in Group U within the 7 postoperative days compared with Group C;however,therewere not significant differences in pain scores among different groups 1 month aftersurgery.Pain relief after the removal of chest tubes was found only in GroupB(P=0.020).The incidence of morbidity was similar among the 3 groups.Conclusion Protectionof bilateral intercostal nerves around the incision contributes to significant pain reliefafter operation without increase of the morbidity of complications. Key words: Intercostalnerves; Pain,postoperative; Thoracic surgical procedures