Post-Thoracotomy Analgesia for Rib Fixation in Sub-Saharan Africa: A Randomized Trial Demonstrates Efficacy of Intercostal Bupivacaine Infiltration

Abstract

What this study adds: In this double-blind randomized controlled trial, intercostal bupivacaine infiltration reduced 24-hour postoperative morphine consumption by 34% (29 mg vs. 44 mg under placebo; p=0.04). It also significantly lowered pain scores at every assessment up to 48 hours, without increasing adverse events. Implications: This study validates a robust and accessible analgesic technique for patients undergoing thoracotomy in resource-limited settings. Its adoption could improve postoperative care standards, reduce reliance on systemic opioids and their side effects, and potentially shorten hospital stay. It calls for its integration into standard protocols and warrants cost-effectiveness studies. This publication is available in full in Health Sciences and Disease.