Subpleural anesthesia at thoracic surgery
Subpleural anesthesia (SPA) was proposed by L. Nunn and G. Slavin [4] in 1989 and is considered as a modified method of intercostal block. When injected into the subpleural space that is connected to the epidural space through the intervertebral foramens, the anesthetic spreads upwards, downward, and into the paravertebral area. SPA is used for perioperative anesthesia during operations on the breast, gallbladder, kidneys, etc. The authors consider the efficiency of SPA as an anesthetic maintenance method during thoracic interventions. The investigation covered 83 patients aged 18-66 years. SPA in combination with neuroleptic analgesia (NLA) was applied to Group 1 patients. Group 2 patients received NLA (a control group). The investigation has demonstrated that SPA in combination with NLA is an effective mode of anesthesia at thoracic surgery and considerably reduces the dose of narcotic analgesics and neuroleptics, by preserving the adequacy of anesthesia.