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Thoracotomy analgesia

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https://www.readbyqxmd.com/read/29911573/managing-post-thoracotomy-pain-epidural-or-systemic-analgesia-and-extended-care-a-randomized-study-with-an-as-usual-control-group
#1
Elina Tiippana, Kaisa Nelskylä, Eija Nilsson, Eero Sihvo, Matti Kataja, Eija Kalso
Background and aims Thoracotomies can cause severe pain, which persists in 21-67% of patients. We investigated whether NSAID + intravenous patient-controlled analgesia (IV-PCA) with morphine is an efficacious alternative to thoracic epidural analgesia (TEA). We also wanted to find out whether an extended controlled pain management protocol within a clinical study can decrease the incidence of persistent post-thoracotomy pain. Methods Thirty thoracotomy patients were randomized into 3 intervention groups with 10 patients in each...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29901652/the-effects-of-preoperative-single-dose-thoracic-paravertebral-block-on-acute-and-chronic-pain-after-thoracotomy-a-randomized-controlled-double-blind-trial
#2
Xiu-Liang Li, Ye Zhang, Tian Dai, Lei Wan, Guan-Nan Ding
BACKGROUND: Patients undergoing thoracotomy frequently experience acute pain and chronic post-thoracotomy pain (CPTP). There are few articles relating to the investigations on the effects of preoperative single-dose thoracic paravertebral block (PSTPVB) on acute pain and CPTP. We tested the hypothesis that adding PSTPVB to intravenous (IV) patient-controlled analgesia (PCA) would reduce acute pain scores and decrease the incidence and intensity of CPTP. METHODS: Fifty-six patients undergoing elective thoracotomy were randomized to receive PSTPVB in addition to IV PCA (group T) or IV PCA alone (group C)...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29850137/pregabalin-as-an-analgesic-option-for-patients-undergoing-thoracotomy-cost-analysis-of-pregabalin-versus-epidural-analgesia-for-post-thoracotomy-pain-relief
#3
Noriyuki Matsutani, Hitomi Yamane, Toshiaki Suzuki, Aya Murakami, Yuri Haga, Masafumi Kawamura
Background: Our previous randomized controlled trial (RCT) to evaluate the effects of pregabalin on acute post-thoracotomy pain compared with epidural analgesia showed that pregabalin is a safe and effective treatment and that it may be an alternative to epidural analgesia for acute post-thoracotomy pain. In this analysis, to additionally analyze the economic aspects of pregabalin in patients undergoing thoracotomy, we compared the medical costs between pregabalin and epidural analgesia as an analgesic technique for post-thoracotomy pain...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29794944/use-of-serratus-plane-block-for-repair-of-coarctation-of-aorta-a-report-of-3-cases
#4
Abhijit Biswas, Igor Luginbuehl, Elod Szabo, Monica Caldeira-Kulbakas, Mark W Crawford, Tobias Everett
OBJECTIVES: The practice of regional anesthesia techniques (thoracic, epidural, paravertebral) in pediatric cardiac surgery enhances perioperative outcomes such as improved perioperative analgesia, decreased stress response, early extubation, and shortened hospital stay. However, these blocks can be technically challenging and can be associated with unacceptable failure rate and complications in infants. For these reasons, regional anesthesia is sometimes avoided in pediatric cardiac surgery...
May 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29794802/continuous-erector-spinae-plane-catheter-for-analgesia-after-infant-thoracotomy-a-case-report
#5
Irem Kaplan, York Jiao, Jacob Daniel AuBuchon, Robert P Moore
The erector spinae plane block is an emerging technique for the provision of thoracolumbar analgesia with reported pediatric applications. We describe the placement of a continuous erector spinae plane catheter at the T5-T6 level in a 7-month-old infant who was undergoing thoracotomy for left upper lobectomy due to congenital pulmonary airway malformation. This technique resulted in outstanding analgesia without the need for opioid rescue analgesia. This block has a low degree of technical difficulty and is placed in area devoid of nearby critical structures and could be used in a number of potentially painful interventions...
May 23, 2018: A&A practice
https://www.readbyqxmd.com/read/29788532/the-effect-of-adding-magnesium-sulfate-to-epidural-bupivacaine-and-morphine-on-post-thoracotomy-pain-management-a-randomized-double-blind-clinical-trial
#6
Behrooz Farzanegan, Mahdi Zangi, Kimia Saeedi, Ali Khalili, Mehdi Rajabi, Alireza Jahangirifard, Habib Emami, Amir Ali Mahboobipour, Shadi Baniasadi
Post-thoracotomy pain is very severe and may cause pulmonary complications. Thoracic epidural analgesia can greatly decrease the pain experience and its consequences. However, finding new methods to decrease the amount of administered opioids is an important issue of research. We aimed to evaluate the effect of adding epidural magnesium sulfate to bupivacaine and morphine on pain control and the amount of opioid consumption after thoracotomy. Eighty patients undergoing thoracotomy at a tertiary cardiothoracic referral centre were enrolled in a randomized, double-blind trial...
May 22, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29780712/advantages-of-wound-retractor-device-versus-rigid-trocar-at-camera-port-in-video-assisted-thoracic-surgery-a-single-institution-experience
#7
Federico Raveglia, Ugo Cioffi, Matilde De Simone, Alessandro Rizzi, Andrea Leporati, Carmine Tinelli, Marco Chiarelli, Alessandro Baisi
Background: rigid trocars are widely adopted in video-assisted thoracic surgery (VATS), despite some disadvantages: (I) cannula strong pressure on intercostal nerve stimulating postoperative pain; (II) limited movement of thoracoscopic devices on their fulcrum when extreme acute angles with the chest wall are needed. Wound retractor (WR) device, designed for laparoscopic surgery, it is also used in VATS, but to protect mini-thoracotomy. We compared the use of extra-small WR versus rigid trocar at camera port that is the most painful thoracostomy...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29770535/ultrasound-guided-transversus-thoracic-plane-block-parasternal-block-and-fascial-planes-hydrodissection-for-internal-mammary-post-thoracotomy-pain-syndrome
#8
Emanuele Piraccini, Giulia Biondi, Helen Byrne, Morena Calli, Daniele Bellantonio, Giovanni Musetti, Stefano Maitan
INTRODUCTION: Pectoral Nerves Block (PECS) and Serratus Plane Block (SPB) have been used to treat persistent post-surgical pain after breast and thoracic surgery, however they cannot block the internal mammary region, so a residual pain may occur in that region. Parasternal block (PSB) and Thoracic Transversus Plane Block (TTP) anesthetize the anterior branches of T2-6 intercostal nerves thus they can provide analgesia to the internal mammary region. METHODS: We describe a 60-year-old man suffering from right post thoracotomy pain syndrome with residual pain located in the internal mammary region after a successful treatment with PECS and SPB We performed a PSB and TTP and hydrodissection of fascial planes with triamcinolone and Ropivacaine...
May 16, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29763594/patient-controlled-paravertebral-block-for-video-assisted-thoracic-surgery-a-randomized-trial
#9
Zixiang Wu, Shuai Fang, Qi Wang, Cong Wu, Tianwei Zhan, Ming Wu
BACKGROUND: Paravertebral block (PVB) has been proven to be an efficient way to control postoperative pain in patients who have undergone a thoracotomy. This study aimed to explore whether the utilization of a patient-controlled PVB can provide benefits over intravenous patient-controlled analgesia (PCA) for three-port single-intercostal video-assisted thoracic surgery. METHODS: From May 2015 to December 2016, patients who had solitary pulmonary nodules or spontaneous pneumothorax and underwent single-intercostal video-assisted thoracic surgery were randomly allocated to receive patient-controlled PVB or intravenous PCA...
May 12, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29701425/analgesia-management-for-mitral-valve-repair-via-minithoracotomy-a-case-report
#10
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29694674/local-anaesthetics-and-regional-anaesthesia-versus-conventional-analgesia-for-preventing-persistent-postoperative-pain-in-adults-and-children
#11
REVIEW
Erica J Weinstein, Jacob L Levene, Marc S Cohen, Doerthe A Andreae, Jerry Y Chao, Matthew Johnson, Charles B Hall, Michael H Andreae
BACKGROUND: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017. OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing elective surgery. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to December 2016 without any language restriction...
April 25, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29684994/postoperative-infusion-of-a-low-dose-of-dexmedetomidine-reduces-intravenous-consumption-of-sufentanil-in-patient-controlled-analgesia
#12
Dae-Eun Kweon, Youngbin Koo, Seonyi Lee, Kumhee Chung, Sowoon Ahn, Chunghyun Park
BACKGROUND: Combining adjunctive medications with patient-controlled analgesia (PCA) has been used to minimize opioid related side-effects. The aim of this study was to evaluate whether postoperative infusion of a sub-sedative dose of dexmedetomidine can reduce opioid consumption and opioid related side-effects. METHODS: We selected 60 patients from 18 to 60 years old with an American Society of Anesthesiologists physical status of 1-2 who were scheduled for elective surgery...
June 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29553987/chronic-postsurgical-pain-and-cancer-the-catch-of-surviving-the-unsurvivable
#13
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...
June 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
#14
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
#15
LETTER
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
#16
Linda W Martin, Bethany M Sarosiek, Meredith A Harrison, Traci Hedrick, James M Isbell, Alexander S Krupnick, Christine L Lau, J Hunter Mehaffey, Robert H Thiele, Dustin M Walters, Randal S Blank
BACKGROUND: To minimize the stress of operations, improve the patient experience, reduce variability, and optimize resource utilization, we implemented a thoracic enhanced recovery after surgery (ERAS) protocol and evaluated progress after 1 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
#17
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
#18
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
#19
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
#20
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
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