The effective use of intrapleural bupivacaine for analgesia after thoracic and subcostal incisions in children.

Twenty-four patients having undergone thoracotomies and subcostal incisions were treated for 24 hours with intrapleural bupivacaine with epinephrine. Vital signs, pain scores, and serum bupivacaine levels were recorded. No patient required narcotic medications and all patients obtained adequate analgesia. There were no complications of the technique or toxicity of the drug. Further studies need to be performed to extend the duration of use, to determine pharmacokinetics, and to compare with other techniques.