Transmission of pain sensation via the right phrenic nerve during cholecystectomy
Asano, M.; Ohta, K.; Imaizumi, H.; Kashiki, K.
Masui. Japanese Journal of Anesthesiology 35(4): 599-604
1986
ISSN/ISBN: 0021-4892 PMID: 3018310 Document Number: 272741
We investigated the role of the right phrenic nerve in conduction of pain sensation by examining the effect of phrenic nerve block, supplementing thoracic epidural anesthesia during cholecystectomy, on the intraoperative courses. Thirty six patients scheduled for elective cholecystectomy under thoracic epidural anesthesia were studied. Eighteen patients were operated under thoracic epidural anesthesia (non-block group) and the other 18 patients under thoracic epidural anesthesia and right phrenic nerve block (block group). These patients were administered neither with inhalational anesthetics nor with neuromuscular blocking agents. Twelve patients (67%) of the non-block group complained of pain during operative procedures. Of these patients, six complained of chest pain, three of right shoulder pain, two of anterior neck pain, and one patient of headache. Whereas in the block group, only four patients (22%) complained of left shoulder pain and the other patients were free from pain during the entire intraoperative course. The right phrenic nerve block reduced the frequency of the pain significantly during cholecystectomy (P < 0.01). The result suggests that the right phrenic nerve has an important role in transmitting pain caused by the stimulation of the central part of the diaphragm during cholecystectomy.