VATS guided intercostal nerve block
VATS guided intercostal nerve block
Successful injection is confirmed by seeing a sausage shaped elevation of the pleura in each intercostal space. This bolus of Chirocaine lasts for approximately 24 hours which gets the patient over the initial postoperative period. I would favour moving to a longer infusion time, though we are currently having difficulties obtaining suitable cannulae and tunnelling devices. We continue our efforts to research the available devices. Unfortunately standard epidural cannulae tend not to be satisfactory as they are too fine, too flexible and do not have enough holes along the length of the catheter to anaesthetise multiple intercostal spaces.