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Thoracotomy analgesia

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https://www.readbyqxmd.com/read/28805780/-regional-and-peripheral-blockades-for-prevention-of-chronic-post-thoracotomy-pain-syndrome-in-oncosurgical-practice
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28624032/epidural-analgesia-for-traumatic-rib-fractures-is-associated-with-worse-outcomes-a-matched-analysis
#5
Katherine M McKendy, Lawrence F Lee, Kerianne Boulva, Dan L Deckelbaum, David S Mulder, Tarek S Razek, Jeremy R Grushka
BACKGROUND: The optimal method of pain control for patients with traumatic rib fractures is unknown. The aim of this study was to determine the effect of epidural analgesia on respiratory complications and in-hospital mortality in patients with rib fractures. METHODS: Adult patients at a level I trauma center with ≥1 rib fracture from blunt trauma were included (2004-2013). Those with a blunt-penetrating mechanism, traumatic brain injury, or underwent a laparotomy or thoracotomy were excluded...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28614112/serratus-anterior-plane-block-to-address-postthoracotomy-and-chest-tube-related-pain-a-report-on-3-cases
#6
George M Chu, G Craig Jarvis
In this case report, the serratus anterior plane block was used in conjunction with multilevel continuous thoracic paravertebral blocks (TPVB) and general anesthesia in 3 thoracotomy cases. All blocks were accompanied by use of catheters that allowed continuous local anesthetic infusions and intermittent local anesthetic bolus injections to address postoperative pain. In all 3 patients, the serratus anterior plane block provided analgesia for chest tube-related pain that was not provided by the TPVB alone.
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#7
RANDOMIZED CONTROLLED TRIAL
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28447227/the-efficacy-of-serratus-anterior-plane-block-in-analgesia-for-thoracotomy-a-retrospective-study
#8
Korgün Ökmen, Burcu Metin Ökmen
PURPOSE: A multimodal analgesic approach is necessary for post-thoracotomy pain, which can be severe. Intravenous access, central and peripheral nerve blocks are frequently used. The aim of this study was to evaluate the efficacy of serratus anterior plane block (SAPB) in the management of post-thoracotomy pain. METHODS: A total of 40 patients who underwent thoracotomy between January 2014 and January 2016 were retrospectively analyzed. The patients were divided into two groups: Group M (intravenous patient-controlled analgesia morphine; n = 20) and Group S (intravenous patient-controlled analgesia morphine + SAPB; n = 20)...
August 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28339431/perioperative-ketamine-administration-for-thoracotomy-pain
#9
REVIEW
Daniel W Moyse, Alan D Kaye, James H Diaz, Muhammad Y Qadri, David Lindsay, Srinivas Pyati
BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28306584/serratus-anterior-plane-block-to-address-post-thoracotomy-and-chest-tube-related-pain-a-report-on-3-cases
#10
George M Chu, G Craig Jarvis
In this case report, the serratus anterior plane block was used in conjunction with multilevel continuous thoracic paravertebral blocks (TPVB) and general anesthesia in 3 thoracotomy cases. All blocks were accompanied by use of catheters that allowed continuous local anesthetic infusions and intermittent local anesthetic bolus injections to address postoperative pain. In all 3 patients, the serratus anterior plane block provided analgesia for chest tube-related pain that was not provided by the TPVB alone.
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28304084/surgical-versus-non-surgical-management-for-pleural-empyema
#11
REVIEW
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28275918/robotic-thoracic-surgery-results-in-shorter-hospital-stay-and-lower-postoperative-pain-compared-to-open-thoracotomy-a-matched-pairs-analysis
#12
Christopher Darr, Danjouma Cheufou, Gerhard Weinreich, Thomas Hachenberg, Clemens Aigner, Sandra Kampe
BACKGROUND: To evaluate postoperative pain intensity and length of hospital stay after open or robotic thoracic surgery in a standardized postoperative pain therapy setting. METHODS: In the present retrospective (oberservation period: January 2015 until January 2016) study we matched data of 38 patients with robotic thoracic surgery ("robotic patients"; age: 62.2 years, male gender: 42.1%) with 38 patients with open thoracic surgery ("open patients"; age: 62.5 years, male gender: 42...
March 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28252817/postoperative-pain-experiences-in-chinese-adult-patients-after-thoracotomy-and-video-assisted-thoracic-surgery
#13
Hui Wang, Shanqing Li, Naixin Liang, Wei Liu, Hongju Liu, Huaping Liu
AIMS AND OBJECTIVES: To investigate the developing course of postoperative pain in a Chinese sample of patients following thoracic surgery. BACKGROUND: Chronic postoperative pain following thoracic surgery including both thoracotomy and video-assisted thoracic surgery is often reported. However, research on pain trends concerning this topic is scarce with a notable lack of culturally focused studies by nurses. DESIGN: A prospective observational study...
March 2, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28252539/continuous-erector-spinae-plane-block-for-rescue-analgesia-in-thoracotomy-after-epidural-failure-a-case-report
#14
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
The ultrasound-guided erector spinae plane (ESP) block is a newly described technique for providing thoracic analgesia. It is simple to perform and relatively noninvasive compared with thoracic epidural analgesia. In addition, the anatomy lends itself well to catheter insertion for continuous blockade. In this report, we describe the use of the ESP block as a rescue analgesic technique for postthoracotomy analgesia in a patient with failed thoracic epidural analgesia.
May 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28249614/effect-of-dexmedetomidine-combined-with-sufentanil-for-post-thoracotomy-intravenous-analgesia-a-randomized-controlled-clinical-study
#15
Chun-Shan Dong, Jun Zhang, Qiang Lu, Peng Sun, Jun-Ma Yu, Chao Wu, Hao Sun
BACKGROUND: Few studies have investigated the use of dexmedetomidine in patient-controlled intravenous analgesia (PCIA) after thoracic surgery. This study to evaluate the effect of dexmedetomidine combined with sufentanil for PCIA after thoracotomy under general anaesthesia. METHODS: Ninety-seven adults patients scheduled for thoracotomy surgery. All two groups received PCIA with either sufentanil alone (control group) or combining dexmedetomidine with sufentanil (dexmedetomidine group)...
March 1, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28217054/role-of-intercostal-nerve-block-in-reducing-postoperative-pain-following-video-assisted-thoracoscopy-a-randomized-controlled-trial
#16
Zulfiqar Ahmed, Khalid Samad, Hameed Ullah
BACKGROUND: The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28149551/is-early-postoperative-administration-of-pregabalin-beneficial-for-patients-with-lung-cancer-randomized-control-trial
#17
Takuro Miyazaki, Tetsuya Sakai, Shuntaro Sato, Naoya Yamasaki, Tomoshi Tsuchiya, Keitaro Matsumoto, Ryotaro Kamohara, Go Hatachi, Ryoichiro Doi, Takeshi Nagayasu
BACKGROUND: Post-thoracotomy pain is an obstacle for lung-cancer patients even after introduction of less invasive surgical procedures. The aim of this prospective study was to evaluate if early postoperative administration of pregabalin is beneficial for patients with non-small cell lung cancer (NSCLC). METHODS: We conducted a randomized open control trial. Patients with NSCLC were allocated randomly to epidural and nonsteroidal anti-inflammatory drug (NSAID) use for analgesia (control group) or pregabalin use (pregabalin group)...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28122571/continuous-paravertebral-block-using-a-thoracoscopic-catheter-insertion-technique-for-postoperative-pain-after-thoracotomy-a-retrospective-case-control-study
#18
Yoshikane Yamauchi, Mitsuhiro Isaka, Kamon Ando, Keita Mori, Hideaki Kojima, Tomohiro Maniwa, Shoji Takahashi, Eiji Ando, Yasuhisa Ohde
BACKGROUND: Thoracic epidural analgesia (EDA) is the gold standard for pain control after thoracotomy. However, because of its severe side effects, it is contraindicated in patients taking anticoagulant or antiplatelet drugs. In addition, some patients' anatomy can make epidural catheter insertion challenging. We therefore investigated the safety and efficacy of paravertebral block (PVB) using a thoracoscopic insertion technique, which avoids damage to the parietal pleura, for postoperative pain after thoracotomy...
January 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28115866/serratus-anterior-plane-block-for-hybrid-transthoracic-esophagectomy-a-pilot-study
#19
Cinzia Barbera, Pamela Milito, Michele Punturieri, Emanuele Asti, Luigi Bonavina
BACKGROUND: Pain is a major limiting factor in patient's recovery from major thoracic surgical procedures. Thoracic epidural analgesia (TEA), the current gold standard of perioperative management, has contraindications, can technically fail, and carries a risk of complications such as epidural abscess and spinal hematoma. The ultrasound-guided serratus anterior plane (SAP) block is a promising regional analgesia technique. OBJECTIVES: Since the anatomic space involved in the SAP block corresponds to the area exposed by the surgeon during right posterolateral thoracotomy, we investigated the feasibility of a "surgically guided" continuous SAP block as an alternative to TEA in selected esophagectomy patients...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28096575/the-effect-of-epidural-dexmedetomidine-on-oxygenation-and-shunt-fraction-in-patients-undergoing-thoracotomy-and-one-lung-ventilation-a-randomized-controlled-study
#20
Prachi Kar, Padmaja Durga, Ramachandran Gopinath
BACKGROUND AND AIMS: Role of epidural dexmedetomidine in providing analgesia is well documented, but its effect on oxygenation and shunt fraction is not well established. We studied the hypothesis that epidural dexmedetomidine may improve oxygenation and shunt fraction during one-lung ventilation (OLV). MATERIAL AND METHODS: After taking Institutional Ethics Committee approval, sixty patients undergoing thoracotomy and OLV were randomized to receive epidural ropivacaine with saline (RS group) or epidural ropivacaine with dexmedetomidine (RD group)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
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