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Pain. Give me Bupivacaine.
Skeptik Reviewer: Dr. Ali Albargawi
Clinical Fellow, Senior Resident, Working Bee, New Dad, Jimmy the Bupivacaine Giver
Case: Your 65 year old female patient is requesting something for pain before her thoracotomy for lung cancer resection. She saw a movie on Netflix about Bupivacaine and wondered if that’s something she could have.
Reference:Nosotti M, Rosso L, Tosi D, Palleschi A, Mendogni P, Righi I, Marenghi C, Santambrogio L. Preventive analgesia in thoracic surgery: controlled, randomized, double-blinded study. Eur J Cardiothorac Surg. 2014 Dec 18. pii: ezu467. PMID: 25527168
Clinical Question: what is the efficacy of preoparative Dextromethorphan associated with Intercostal nerve Block (IB) using Levobupivacaine
Author’s Conclusions: PreOp administration of Dextromethorphan with PreOp IB using Levobupivacaine can provide preventive analgesia decreasing analgesic administration during the early PostOp period.
A. Are the results valid?
B. What are the results?
C. Do the results apply to my patients?
Key Results: early postop period vs post thoracotomy syndrome.
Skeptik BEST Commentary:
Comment on authour’s conclusion vs. Skeptik BETS conclusion:
What is the take home message?
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