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Thoracotomy analgesia

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https://www.readbyqxmd.com/read/29180206/ropivacaine-wound-infiltration-a-fast-track-approach-in-patients-undergoing-thoracotomy-surgery
#1
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
#2
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-utilizing-local-anesthesia-and-sedation-lessons-learned
#3
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 the author began utilizing local anesthesia and sedation for pleural disease and subsequently for pericardial and lung disease. STUDY DESIGN: The records of all patients undergoing VATS utilizing local anesthesia and sedation at hospitals of the Geisinger Health System (Danville and Wilkes-Barre, PA) June 1, 2002 to June 30, 2011 and the Lifebridge Health System (Baltimore, MD) July 1, 2011 to March 1, 2017 were retrospectively reviewed...
October 13, 2017: 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
#4
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
#5
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
#6
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...
September 11, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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