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Thoracotomy analgesia

Ke-Vin Chang, Wei-Ting Wu, Chen-Yu Hung, Der-Sheng Han, Rong-Sen Yang, Chung-Hsun Chang, Chih-Peng Lin
BACKGROUND: The suprascapular nerve accounts for 70% of shoulder sensory innervations, and suprascapular nerve block (SSNB) has been shown to be effective in the relief of chronic shoulder pain including rotator cuff tendinitis, subdeltoid impingement syndrome, and adhesive capsulitis. However, this remains inconclusive for patients undergoing surgery. The present meta-analysis aimed to explore the effectiveness of SSNB for relieving acute post-operative shoulder pain. OBJECTIVE: To explore the effectiveness of SSNB for relieving acute post-operative shoulder pain...
September 2016: Pain Physician
Sandra Kampe, Bianca Geismann, Gerhard Weinreich, Georgios Stamatis, Uwe Ebmeyer, Hans J Gerbershagen
BACKGROUND:  Chronic post-thoracotomy pain (CPP) has a high incidence. However, less is known about risk factors and the influence of different analgesia therapies. METHODS:  In this prospective cohort study, patients either received standardized epidural analgesia or began an oral analgesic protocol with controlled-release oxycodone immediately postoperatively. Patients answered a baseline questionnaire on the day before surgery and a follow-up questionnaire six months postoperatively...
September 20, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Julian J Nesbitt, George Mori, Charlotte Mason-Apps, George Asimakopoulos
OBJECTIVE: Minimally invasive coronary artery bypass surgery performed through a left thoracotomy has potential benefits over conventional sternotomy, including reduced surgical trauma, faster recovery and potential improvement in quality of life. This study is a prospective assessment of quality of life in patients undergoing off-pump coronary bypass by median sternotomy and left anterior thoracotomy. METHODS: Quality of life was assessed by the EuroQoL questionnaire, with additional questions on dyspnoea, angina, wound pain and scar aesthetics...
July 20, 2016: Perfusion
Korgün Okmen, Burcu Metin Okmen, Serkan Uysal
Thoracotomy is a surgical technique used to reach the thoracic cavity. Management of pain due to thoracotomy is important in order to protect the operative respiratory reserves and decrease complications. For thoracotomy pain, blocks (such as thoracic epidural, paravertebral, etc.) and pleural catheterization and intravenous drugs (such as nonsteroidal anti-inflammatory drugs [NSAIDs], and opioids, etc., can be used. We performed a serratus anterior plane (SAP) block followed by catheterization for thoracotomy pain...
July 2016: Korean Journal of Pain
J Matek, P Michálek, S Trča, Z Krška
UNLABELLED: Postoperative pain management is an important part of complex perioperative care in patients undergoing thoracotomy, irrespective of the procedure type. Adequate pain relief leads to early mobilisation, improves respiratory functions and decreases global stress response. Thus, good perioperative pain management significantly reduces postoperative complications. Currently, numerous analgesic methods are available for the management of acute postthoracotomy pain including patient- or nurse-controlled systemic administration of analgesics, infiltration with local anaesthetics, intrapleural or intercostal nerve blockades and neuroaxial blocks (paravertebral, intrathecal, epidural)...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Michelle A O Kinney, Adam K Jacob, Melissa A Passe, Carlos B Mantilla
Background. Postthoracotomy pain syndrome (PTPS) is unfortunately very common following thoracotomy and results in decreased quality of life. The purpose of this retrospective study was to determine perioperative patient, surgical, and analgesic characteristics associated with the development of PTPS. Methods. Sixty-six patients who presented to the Mayo Clinic Rochester Pain Clinic were diagnosed with PTPS 2 months or more after thoracotomy with postoperative epidural analgesia. These patients were matched with sixty-six control patients who underwent thoracotomy with postoperative epidural analgesia and were never diagnosed with PTPS...
2016: Pain Research and Treatment
Kristin L Schreiber, Jacques E Chelly, R Scott Lang, Ezeldeen Abuelkasem, David A Geller, J Wallis Marsh, Allan Tsung, Tetsuro Sakai
BACKGROUND AND OBJECTIVES: Although many studies have found no difference between thoracic epidural block and unilateral thoracic paravertebral block after thoracotomy, no previous studies have compared epidural block with bilateral thoracic paravertebral block (bTPVB) in patients undergoing open liver resection. We aimed to investigate whether there was a significant analgesic advantage of thoracic epidural over bTPVB after liver resection. METHODS: This randomized, prospective, open-label study included adult patients undergoing elective open liver resection...
July 2016: Regional Anesthesia and Pain Medicine
Tülün Öztürk, İsmet Topcu, Sadık Yaldız, Alper Özbakkaloğlu, Kıvanç Aşık, Alp Yentürk
OBJECTIVES: In the present randomized, controlled, and blinded study, the effects of thoracic paravertebral analgesia were compared to those of epidural analgesia on postoperative pain, hemodynamics, and respiration rate following thoracotomy. METHODS: Patients scheduled for elective open-lung surgery were included. One hour prior to surgery, thoracic epidural catheters were used in 18 patients (ED group), and ultrasound-guided paravertebral catheters were used in 17 patients (PV group)...
January 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Larry Carbone, Jamie Austin
Scientists who perform major survival surgery on laboratory animals face a dual welfare and methodological challenge: how to choose surgical anesthetics and post-operative analgesics that will best control animal suffering, knowing that both pain and the drugs that manage pain can all affect research outcomes. Scientists who publish full descriptions of animal procedures allow critical and systematic reviews of data, demonstrate their adherence to animal welfare norms, and guide other scientists on how to conduct their own studies in the field...
2016: PloS One
Xiao-Min Ling, Fang Fang, Xiao-Guang Zhang, Ming Ding, Qiu-A-Xue Liu, Jing Cang
BACKGROUND: Thoracotomy results in severe postoperative pain potentially leading to chronic pain. We investigated the potential benefits of intravenous parecoxib on postoperative analgesia combined with thoracic epidural analgesia (TEA). METHODS: Eighty-six patients undergoing thoracic surgery were randomized into two groups. Patient-controlled epidural analgesia (PCEA) was used until chest tubes were removed. Patients received parecoxib (group P) or placebo (group C) intravenously just 0...
May 2016: Journal of Thoracic Disease
Tim Murphy, Alan McCheyne, Jacob Karlsson
BACKGROUND: It is important that postoperative analgesic management after thoracotomy is very effective in order to optimize postoperative recovery. A regional technique such as an epidural or a paravertebral catheter with an infusion of local anesthetic may be supplemented with systemically administered analgesic drugs in order to achieve satisfactory analgesia. OBJECTIVE: The objective of this observational study was to evaluate whether a paravertebral infusion of local anesthetic delivered via a surgically placed catheter together with systemic analgesics is associated with low pain scores and satisfactory analgesia after thoracotomy for decortication in children...
July 2016: Paediatric Anaesthesia
Andrea Imperatori, Annamaria Grande, Massimo Castiglioni, Laura Gasperini, Agnese Faini, Sebastiano Spampatti, Elisa Nardecchia, Lorena Terzaghi, Lorenzo Dominioni, Nicola Rotolo
OBJECTIVES: Kinesiology taping (KT) is a rehabilitative technique performed by the cutaneous application of a special elastic tape. We tested the safety and efficacy of KT in reducing postoperative chest pain after lung lobectomy. METHODS: One-hundred and seventeen consecutive patients, both genders, age 18-85, undergoing lobectomy for lung cancer between January 2013 and July 2015 were initially considered. Lobectomies were performed by the same surgical team, with thoracotomy or video-assisted thoracoscopic surgery (VATS) access...
August 2016: Interactive Cardiovascular and Thoracic Surgery
Sevilay Erden, Sevilay Senol Celik
BACKGROUND: Pain guidelines suggest transcutaneous electrical nerve stimulation (TENS) as a reliable analgesic method in postoperative pain. OBJECTIVES: This study was conducted as a randomized controlled study to determine the effect of TENS on postoperative pain and analgesic consumption in patients who have undergone posterolateral thoracotomy (PLT). DESIGN: The study was conducted in the Thoracic Surgery Clinic of a university hospital with 40 patients (test group: 20, control group: 20) and its power was 99%...
October 2015: Contemporary Nurse
Joyce H Y Yeung, Simon Gates, Babu V Naidu, Matthew J A Wilson, Fang Gao Smith
BACKGROUND: Operations on structures in the chest (usually the lungs) involve cutting between the ribs (thoracotomy). Severe post-thoracotomy pain can result from pleural (lung lining) and muscular damage, costovertebral joint (ribcage) disruption and intercostal nerve (nerves that run along the ribs) damage during surgery. Poor pain relief after surgery can impede recovery and increase the risks of developing complications such as lung collapse, chest infections and blood clots due to ineffective breathing and clearing of secretions...
2016: Cochrane Database of Systematic Reviews
Abdolhossein-Davoodabadi, Mohammad Reza-Fazel, Hamid Reza-Vafaei, Shohreh Parviz
BACKGROUND: Post-thoracotomy pain is the most severe types of postoperative pain. This study compares the effects of intrapleural bupivacaine and morphine on post-thoracotomy pain. METHODS: In a double blind clinical trial study, 30 patients candidate for unilateral thoracotomy were randomly divided into bupivacaine and morphine groups. Patients in the morphine group received 0.2 mg/kg morphine and those in the bupivacaine group received 1 mg/kg bupivacaine by an intrapleural catheter placed at the end of surgery by direct vision...
October 2015: Middle East Journal of Anesthesiology
Stephan R Williams, Marc Belliveau, Veronique Brulotte, Monique M Ruel
PURPOSE: The purpose of this prospective randomized controlled trial was to determine the impact of thoracic epidural catheter threading distance on analgesia quality after thoracotomy. METHODS: We randomly assigned 120 elective thoracotomy patients to a thoracic epidural catheter threading distance of 3, 5, or 7 cm (groups 3CM, 5CM, and 7CM, respectively). Epidural bupivacaine 0.1% with fentanyl 2 µg·mL(-1) was administered according to a standardized protocol...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Harald Ihmsen, Doris Rohde, Jürgen Schüttler, Christian Jeleazcov
BACKGROUND AND OBJECTIVE: We recently developed a new population pharmacokinetic model for hydromorphone in patients including age and bodyweight as covariates. The aim of the present study was to evaluate prospectively the predictive performance of this new model during postoperative pain therapy. METHODS: This was a prospective, single-blinded, randomized, single-center study with two parallel arms. Fifty patients aged 40-85 years undergoing cardiac surgery involving thoracotomy were enrolled...
January 21, 2016: European Journal of Drug Metabolism and Pharmacokinetics
Yutaka Murata, Toshiyuki Mizota, Kazuhiko Fukuda
BACKGROUND: Hybrid video-assisted thoracic surgery (hybrid VATS), combining television monitoring and direct visualization through mini-thoracotomy, has been established as a secure and minimally invasive operation for lung cancer. This study aimed to determine postoperative pain levels after hybrid VATS in which intraoperative internal intercostal nerve block is performed. We also examined whether additional use of postoperative continuous infusion of fentanyl improves postoperative pain control...
December 2015: Masui. the Japanese Journal of Anesthesiology
Gultekin Gulbahar, Ahmet Gokhan Gundogdu, Güzide Alkan, Hatice Baran Baysalman, Tevfik Kaplan
Management of pain following thoracotomy is an important issue for the control of early morbidity. We herein present the case of a patient who was referred to our hospital after a fall from a height. Right-sided multiple rib fractures, hemopneumothorax, and diaphragmatic rupture were detected. Thoracic epidural catheterization was performed for pain management just before thoracotomy. The patient developed unilateral anhidrosis postoperatively. We discuss this rare complication of thoracic epidural analgesia with a review of relevant literature...
February 2016: Asian Cardiovascular & Thoracic Annals
Aysu Hayriye Tezcan, Özgür Karakurt, Mehmet Ali Eryazgan, Semih Başkan, Dilşen Hatice Örnek, Ramazan Baldemir, Bülent Koçer, Mustafa Baydar
CONTEXT AND OBJECTIVE: Post-thoracotomy pain is a severe and intense pain caused by trauma to ribs, muscles and peripheral nerves. The current study aimed to compare subpleural analgesia (SPA) with thoracic epidural analgesia (TEA) in patients undergoing thoracotomy. DESIGN AND SETTING: Randomized study at Ankara Numune Education and Research Hospital, in Turkey. METHODS: Thirty patients presenting American Society of Anesthesiologists physical status I-III were scheduled for elective diagnostic thoracotomy...
July 2016: São Paulo Medical Journal, Revista Paulista de Medicina
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