Wound infiltration using ropivacaine - A case of thoracic surgery for bilateral lung cancer

A 58-year-old man was diagnosed with bilateral pulmonary masses on chest radiograph in a routine medical checkup. Computed tomography-guided needle biopsy revealed bilateral lung cancer. Pathological examination revealed squamous cell carcinoma (SCC), 27 mm in diameter, in the left S1+2, with staging of cT1bN0M0, Stage IA, and adenocarcinoma, 45 mm in diameter, on the right S1, with staging of cT2aN2M0, Stage IIIA. We first performed wedge resection of the left lung to remove the left SCC. We used intravenous patient-controlled analgesia (ivPCA) with fentanyl at 1.25 mg + droperidol at 5 mg as postanesthetic analgesia. On postoperative day 8, we performed right upper lobectomy to remove the right adenocarcinoma and used the same volume of ivPCA with the addition of single-dose wound infiltration of ropivacaine. In this method, the surgeon infiltrated all surgical strata with 10 mL of a 0.75% solution of ropivacaine and waited for 5 min after thoracic closure. The numeric pain rating scale (NRS) and patient satisfaction were better with wound infiltration using ropivacaine than without it until 12 h postoperatively.