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Thoracotomy analgesia

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https://www.readbyqxmd.com/read/29553987/chronic-postsurgical-pain-and-cancer-the-catch-of-surviving-the-unsurvivable
#1
Stephen R Humble, Nicolas Varela, Asantha Jayaweera, Arun Bhaskar
PURPOSE OF REVIEW: Chronic postsurgical pain (CPSP) is an important and well recognized cause of much long-term suffering, which in some cases may be preventable and affects many people living with cancer. Unfortunately, general consensus is lacking as to how best reduce the risk of developing CPSP. RECENT FINDINGS: Cancer is now not always a short-lived, fatal disease and is now moving towards a chronic illness. Poorly managed perioperative pain is the greatest risk factor for CPSP...
March 16, 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29530770/enhanced-recovery-decreases-pulmonary-and-cardiac-complications-following-thoracotomy-for-lung-cancer
#2
Robert M Van Haren, Reza J Mehran, Arlene M Correa, Mara B Antonoff, Carla M Baker, Ta Charra Woodard, Wayne L Hofstetter, Gabriel E Mena, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, David C Rice
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to improve postoperative recovery through evidence-based practices including early ambulation, multimodal opioid-sparing analgesia, and reduction of surgical stress. The purpose of this study was to evaluate outcomes following implementation of ERAS in patients undergoing resection for pulmonary malignancy. METHODS: A retrospective review compared outcomes for patients undergoing pulmonary resection for primary lung cancer...
March 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29519230/ultrasound-guided-continuous-erector-spinae-plane-block-for-postoperative-analgesia-in-video-assisted-thoracotomy
#3
V Rao Kadam, J Currie
No abstract text is available yet for this article.
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29510097/implementing-a-thoracic-enhanced-recovery-program-lessons-learned-in-the-first-year
#4
Linda Martin, Bethany Sarosiek, Meredith Harrison, Traci Hedrick, James Isbell, Alexander Krupnick, Christine Lau, Hunter Mehaffey, Robert Thiele, Dustin Walters, Randal Blank
BACKGROUND: To minimize the stress of surgery, improve the patient experience, reduce variability and optimize resource utilization, we implemented a thoracic Enhanced Recovery After Surgery (ERAS) protocol and evaluated progress after one year. METHODS: Two protocols were developed: video assisted thoracic surgery (ERAS-VATS) and thoracotomy (ERAS-T). Each incorporated preoperative patient education, carbohydrate loading, opioid-sparing analgesia, conservative fluid management, and early ambulation...
March 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29370900/continuous-erector-spinae-plane-block-for-analgesia-in-pediatric-thoracic-surgery-a-case-report
#5
C Gaio-Lima, C C Costa, J B Moreira, T S Lemos, H L Trindade
Erector spinae plane block has been recently described and it appears as a very promising regional analgesia technique. We report the first continuous erector spinae plane block performed in a pediatric patient for thoracic surgery. A 15-month-old boy, diagnosed with a paracardiac teratoma was scheduled for a tumor resection with a thoracotomy approach. After general anesthesia induction, a continuous erector spinae plane block at T5 level was performed with ropivacaine 0.2%. After surgery, a continuous thoracic interfascial infusion of ropivacaine 0...
January 19, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29327462/propensity-score-matched-outcomes-after-thoracic-epidural-or-paravertebral-analgesia-for-thoracotomy
#6
W J Blackshaw, A Bhawnani, S H Pennefather, O Al-Rawi, S Agarwal, M Shaw
It is not known which regional analgesic technique is most effective or safest after open lung resection. We retrospectively examined outcomes in 828 patients who received thoracic epidural analgesia and 791 patients who received paravertebral block after lung resection between 2008 and 2012. We analysed outcomes for 648 patients, 324 who had each analgesic technique, matched by propensity scores generated with peri-operative data. There were 22 out of 324 (7%) postoperative respiratory complications after thoracic epidural and 23 out of 324 (7%) after paravertebral block, p = 0...
April 2018: Anaesthesia
https://www.readbyqxmd.com/read/29284840/effect-of-clonidine-as-adjuvant-in-thoracic-paravertebral-block-for-patients-undergoing-breast-cancer-surgery-a-prospective-randomized-placebo-controlled-double-blind-study
#7
Nairita Mayur, Anjan Das, Hirak Biswas, Subinay Chhaule, Surajit Chattopadhyay, Tapobrata Mitra, Sandip Roybasunia, Subrata Kumar Mandal
Background and Aims: Postoperative pain after breast cancer surgery is unavoidable. Thoracic paravertebral block (TPVB), a locoregional anesthetic technique, has been proven successful for postoperative pain management in different thoracic surgical procedures, such as thoracotomy, breast cancer surgeries. Clonidine, an adjuvant, in TPVB may enhance the quality and prolong the duration of analgesia. This prospective study was to evaluate the effectiveness of clonidine; administered with TPVB; in addition to conventional local anesthetic solution...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29180206/ropivacaine-wound-infiltration-a-fast-track-approach-in-patients-undergoing-thoracotomy-surgery
#8
RANDOMIZED CONTROLLED TRIAL
Zhuqing Rao, Haoming Zhou, Xiongxiong Pan, Jing Chen, Yuting Wang, Zhongyun Wang, Zhengnian Ding
BACKGROUND: Postoperative pain impairs enhanced recovery in patients after various surgeries. Local use of ropivacaine has become an effective strategy for postoperative pain management. The aim of this study was to assess the effectiveness and safety of wound infiltration with ropivacaine for postoperative analgesia as a fast-track approach in patients undergoing thoracotomy surgery. MATERIALS AND METHODS: Forty adult patients with esophageal cancer scheduled for selective thoracotomy surgery were enrolled in this double-blind, randomized, controlled study...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29169795/paravertebral-block-for-thoracic-surgery
#9
REVIEW
Francine D'Ercole, Harendra Arora, Priya A Kumar
Local anesthetic injected into a wedge-shaped space lateral to the spinal nerves as they emerge from the intervertebral foramina produces somatosensory and sympathetic nerve blockade effective for anesthesia and for managing pain of unilateral origin from the chest and abdomen. Paravertebral blockade (PVB) is versatile and may be applied unilaterally or bilaterally. Unlike thoracic epidural, the PVB technique may be used to avoid contralateral sympathectomy, thereby minimizing hypotension and leading to better preservation of blood pressure...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29037478/five-hundred-seventy-six-cases-of-video-assisted-thoracic-surgery-using-local-anesthesia-and-sedation-lessons-learned
#10
Mark R Katlic
BACKGROUND: General anesthesia and endotracheal intubation are a luxury rather than a necessity for many video-assisted thoracic surgery (VATS) operations. Twenty-three years ago, I began using local anesthesia and sedation for pleural disease and subsequently, for pericardial and lung disease. STUDY DESIGN: The records of all patients undergoing VATS using local anesthesia and sedation at hospitals of the Geisinger Health System (Danville and Wilkes-Barre, PA), from June 1, 2002 to June 30, 2011, and the Lifebridge Health System (Baltimore, MD) from July 1, 2011 to March 1, 2017, were retrospectively reviewed...
January 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29016551/pectoral-fascial-pecs-i-and-ii-blocks-as-rescue-analgesia-in-a-patient-undergoing-minimally-invasive-cardiac-surgery
#11
Suraj Yalamuri, Rebecca Y Klinger, W Michael Bullock, Donald D Glower, Brandi A Bottiger, Jeffrey C Gadsden
INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient undergoing minimally invasive mitral valve repair. CASE REPORT: In this case, a 78-year-old man, with no history of chronic pain, underwent mitral valve repair via right anterior thoracotomy for severe mitral regurgitation...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#12
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#13
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
October 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28892265/effects-of-preemptive-analgesia-with-flurbiprofen-ester-on-lymphocytes-and-natural-killer-cells-in-patients-undergoing-esophagectomy-a-randomized-controlled-pilot-study
#14
Yi Zhou, Jinxi Huang, Yu Bai, Changsheng Li, Xihua Lu
BACKGROUND: Tumors may induce systemic immune dysfunction, which can be aggravated by surgery and anesthesia/analgesia. Data on the effect of flurbiprofen preemptive analgesia on immune dysfunction is limited. The aim of this study was to investigate the effect of flurbiprofen preemptive analgesia on lymphocytes and natural killer (NK) cells in patients undergoing thoracotomy and thoracoscopy radical esophagectomy, and to explore the analgesic methods suitable for tumor patients. METHODS: This was a randomized controlled pilot study of 89 patients with esophageal cancer treated with surgery at the Henan Cancer Hospital between January 1, 2015 and December 31, 2016...
November 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28857802/paravertebral-block-does-not-reduce-cancer-recurrence-but-is-related-to-higher-overall-survival-in-lung-cancer-surgery-a-retrospective-cohort-study
#15
Eun Kyung Lee, Hyun Joo Ahn, Jae Ill Zo, Kyunga Kim, Dae Myung Jung, Joo Hyun Park
BACKGROUND: Postoperative analgesic methods are suggested to have an impact on long-term prognosis after cancer surgery through opioid-induced immune suppression. We hypothesized that regional analgesia that reduces the systemic opioid requirement would be related to lower cancer recurrence and higher overall survival compared to intravenous patient-controlled analgesia (PCA) for lung cancer surgery. METHODS: Records for all patients who underwent open thoracotomy for curative resection of primary lung cancer between 2009 and 2013 in a tertiary care hospital were retrospectively analyzed...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28836009/contralateral-cerebral-hemoglobin-oxygen-saturation-changes-in-patients-undergoing-thoracotomy-with-general-anesthesia-with-or-without-paravertebral-block-a-randomized-controlled-trial
#16
Keika Mukaihara, Maiko Hasegawa-Moriyama, Yuichi Kanmura
PURPOSE: Perioperative analgesia during thoracotomy is often achieved by combining paravertebral block (PVB) with general anesthesia (GA). Functional near-infrared spectroscopy (NIRS) can detect changes in cerebral oxygenation resulting from nociceptive stimuli in the awake state or under sedation. We used NIRS to measure changes in cerebral blood flow provoked by thoracotomy incision made under GA and determine how these changes were influenced by supplementation of GA with PVB. METHODS: Thirty-four patients undergoing elective thoracotomy were enrolled...
December 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28805780/-regional-and-peripheral-blockades-for-prevention-of-chronic-post-thoracotomy-pain-syndrome-in-oncosurgical-practice
#17
RANDOMIZED CONTROLLED TRIAL
V E Khoronenko, A S Malanova, D S Baskakov, A B Ryabov, O V Pikin
AIM: To compare an effectiveness of thoracic epidural anesthesia/analgesia, paravertebral and intercostal blockades in prevention of chronic post-thoracotomy pain syndrome (CPTPS) in oncosurgery. MATERIAL AND METHODS: There were 300 patients who underwent open surgery including lobectomy or pneumonectomy. Patients were randomized into 3 groups depending on type of anesthesia: TEA (n=100) - combined general and epidural anesthesia; PVB (n=50) - combined general and paravertebral anesthesia; ICB (n=50) - general anesthesia was supplemented by intercostal blockade after removal of the drug...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28744155/efficacy-of-single-injection-unilateral-thoracic-paravertebral-block-for-post-open-cholecystectomy-pain-relief-a-prospective-randomized-study-at-gondar-university-hospital
#18
Demeke Yilkal Fentie, Endale Gebreegziabher Gebremedhn, Zewditu Abdissa Denu, Amare Hailekiros Gebreegzi
BACKGROUND: Cholecystectomy can be associated with considerable postoperative pain. While the benefits of paravertebral block (PVB) on pain after thoracotomy and mastectomy have been demonstrated, not enough investigations on the effects of PVB on pain after open cholecystectomy have been conducted. We tested the hypothesis that a single-injection thoracic PVB reduces pain scores, decreases opioid consumption, and prolongs analgesic request time after cholecystectomy. METHODS: Of 52 patients recruited, 50 completed the study...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28740682/combined-analgesic-treatment-of-epidural-and-paravertebral-block-after-thoracic-surgery
#19
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In pulmonary surgical practice, appropriate pain management after thoracotomy is essential for patient recovery and the prevention of complications. Although epidural analgesia (EPI) has been established for chest surgery, it has some limitations and contraindications. Recently, paravertebral block (PVB) was reported as a good alternative method with fewer side effects. Despite the significant effects of these two treatments, postoperative pain remains among the greatest patient burdens. In our institution, we apply a combination of epidural and PVBs after thoracic surgery to reduce pain more effectively...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28638060/epidural-dexmedetomidine-reduces-the-requirement-of-propofol-during-total-intravenous-anaesthesia-and-improves-analgesia-after-surgery-in-patients-undergoing-open-thoracic-surgery
#20
Xianzhang Zeng, Jingjing Jiang, Lingling Yang, Wengang Ding
The aim of this study was to assess the systemic and analgesic effects of epidural dexmedetomidine in thoracic epidural anaesthesia (TEA) combined with total intravenous anaesthesia during thoracic surgery. Seventy-one patients undergoing open thoracotomy were included in this study and randomly divided into three groups: Control group (Group C): patients received TEA with levobupivacaine alone and were intravenously infused with saline; Epidural group (Group E): patients received TEA with levobupivacaine and dexmedetomidine, and were intravenously infused with saline; Intravenous group (group V): patients received TEA with levobupivacaine alone and were intravenously infused with dexmedetomidine...
June 21, 2017: Scientific Reports
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