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Thoracotomy analgesia

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https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#1
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27906718/anesthesia-for-nonintubated-video-assisted-thoracic-surgery
#2
Hiroshi Sunaga, Justin D Blasberg, Paul M Heerdt
PURPOSE OF REVIEW: This review focuses primarily on nonintubated video-assisted thoracic surgery (NIVATS), and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. RECENT FINDINGS: Advancements in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. For thoracic operations in particular, video-assisted thoracic surgery (VATS) has largely replaced traditional thoracotomy, and continued technical development has made surgical access into the pleural space even less disruptive...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27896665/ultrasound-guided-thoracic-paravertebral-block-by-the-paralaminar-in-plane-approach-using-a-microconvex-array-transducer-methodological-utility-based-on-anatomical-structures
#3
Yasuko Taketa, Taro Fujitani, Yumi Irisawa, Satoko Sudo, Kazushi Takaishi
OBJECTIVE: We evaluated the analgesic feasibility of paralaminar in-plane (PL) approach for ultrasound-guided thoracic paravertebral block (USG-TPVB). As the needle trajectory was expected to be closely affected by the distance from the skin to the lamina-transverse process junction (LTPJ), we examined the correlativity between them on computed tomography (CT) or ultrasonography. METHODS: Thirty-two patients undergoing thoracotomy were recruited. We measured the distances between the skin and LTPJ using preoperative CT (S-L) and procedural ultrasonography (US-L)...
November 28, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27871525/a-retrospective-study-of-open-thoracotomies-versus-thoracoscopic-surgeries-for-persistent-postthoracotomy-pain
#4
Harsha Shanthanna, Dina Aboutouk, Eugenia Poon, Ji Cheng, Christian Finley, James Paul, Lehana Thabane
OBJECTIVE: Persistent thoracotomy pain syndrome (PTPS) is a recognized complication and is considered to be less after video-assisted thoracoscopic surgery (VATS) compared with open thoracic surgery (OTS). The primary objective was to compare the incidence of PTPS at 6 months. Secondary objectives were to compare the incidence of neuropathic pain between VATS and OTS and to report perioperative factors associated with the development of PTPS. METHODS: This historical cohort study involved patient contact by a questionnaire regarding the presence of PTPS and its type...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27790554/comparison-between-thoracic-epidural-block-and-thoracic-paravertebral-block-for-post-thoracotomy-pain-relief
#5
Soniya Biswas, Reetu Verma, Vinod Kumar Bhatia, Ajay Kumar Chaudhary, Girish Chandra, Ravi Prakash
INTRODUCTION: Postoperative pain after thoracotomy is being considered one of the most severe pain and if not treated well, can result in various respiratory and other complications. AIM: Present study was conducted with the aim to compare continuous thoracic epidural infusion with continuous paravertebral infusion for postoperative pain using Visual Analogue Scale (VAS) score and four point observer ranking. The secondary outcomes measured were pulmonary functions and any complication like hypotension, bradycardia, nausea, vomiting, urinary retention and neurological complications if any...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27676661/comparative-effectiveness-of-suprascapular-nerve-block-in-the-relief-of-acute-post-operative-shoulder-pain-a-systematic-review-and-meta-analysis
#6
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
https://www.readbyqxmd.com/read/27651509/the-influence-of-type-of-anesthesia-perioperative-pain-and-preoperative-health-status-on-chronic-pain-six-months-after-thoracotomy-a-prospective-cohort-study
#7
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
https://www.readbyqxmd.com/read/27440802/comparison-of-early-and-late-quality-of-life-between-left-anterior-thoracotomy-and-median-sternotomy-off-pump-coronary-artery-bypass-surgery
#8
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
https://www.readbyqxmd.com/read/27413485/serratus-anterior-plane-sap-block-used-for-thoracotomy-analgesia-a-case-report
#9
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
https://www.readbyqxmd.com/read/27410754/-management-of-acute-postoperative-pain-following-thoracotomy-state-of-the-art
#10
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
https://www.readbyqxmd.com/read/27340565/increased-risk-of-postthoracotomy-pain-syndrome-in-patients-with-prolonged-hospitalization-and-increased-postoperative-opioid-use
#11
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
https://www.readbyqxmd.com/read/27281726/epidural-versus-paravertebral-nerve-block-for-postoperative-analgesia-in-patients-undergoing-open-liver-resection-a-randomized-clinical-trial
#12
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
https://www.readbyqxmd.com/read/27225610/-comparison-of-thoracic-epidural-and-paravertebral-analgesia-for-postoperative-pain-control-after-thoracotomy
#13
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
https://www.readbyqxmd.com/read/27171143/pain-and-laboratory-animals-publication-practices-for-better-data-reproducibility-and-better-animal-welfare
#14
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
https://www.readbyqxmd.com/read/27162662/effect-of-parecoxib-combined-with-thoracic-epidural-analgesia-on-pain-after-thoracotomy
#15
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
https://www.readbyqxmd.com/read/27146925/analgesic-management-after-thoracotomy-for-decortication-in-children-a-retrospective-audit-of-83-children-managed-with-a-paravertebral-infusion-based-regime
#16
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
https://www.readbyqxmd.com/read/27130717/chest-pain-control-with-kinesiology-taping-after-lobectomy-for-lung-cancer-initial-results-of-a-randomized-placebo-controlled-study
#17
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
https://www.readbyqxmd.com/read/26986188/the-effect-of-transcutaneous-electrical-nerve-stimulation-on-post-thoracotomy-pain
#18
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
https://www.readbyqxmd.com/read/26897642/paravertebral-block-versus-thoracic-epidural-for-patients-undergoing-thoracotomy
#19
REVIEW
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...
February 21, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26860015/comparison-of-the-effects-of-intrapleural-bupivacaine-and-morphine-on-post-thoracotomy-pain
#20
RANDOMIZED CONTROLLED TRIAL
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
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