04 OA_12.01999 Komatsu.indd

Thoracotomy often causes severe acute postoperative pain, which leads to a high incidence of pulmonary complications.1,2) Unless controlled suffi ciently, impaired pulmonary function can deteriorate.3) Effective pain control following thoracotomy should be a prerequisite for uneventful postoperative recovery. Thoracic epidural analgesia is considered the golden standard for pain control following thoracotomy.4–6) However, there are some complications and contraindications associated with the epidural techniques.6–8) We have introduced continuous infusion of local anesthetics through an indwelling epidural catheter placed in the extrapleural space by surgeons. This technique was originally described and updated by Sabanathan and colleagues.9,10) Most anesthesiologists, as well as general thoracic surgeons, in Japan are not familiar with this method of pain control. The current study is based on the Department of General Thoracic Surgery, Nagara Medical Center, Gifu, Gifu, Japan