Technical Aspects of Common Pain Procedures for Thoracic Surgery

  • Nelson L. Thaemert


For patients undergoing thoracic surgery, postoperative analgesia with local anesthetics can be provided in a variety of forms, including epidural catheters, intercostal blocks, paravertebral blocks, and infusions of local anesthetic within the incisions. When compared to systemic analgesia alone, these techniques can provide many advantages, including reduced opioid use, less respiratory and central nervous system depression, and potentially improved pulmonary mechanics. While analgesia from thoracic epidural catheters is the gold standard for pain relief following thoracic surgery, each of these routes should be considered as potential elements of a comprehensive anesthetic plan.


Thoracic epidural catheters Midline approach Paramedian approach Paramedian thoracic epidural Midline thoracic epidural Intercostal nerve blocks Thoracic paravertebral nerve blocks 

Suggested References

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    Gottschalk A, Cohen SP, et al. Preventing and treating pain after thoracic ­surgery. Anesthesiology. 2006;104(3):594–600.PubMedCrossRefGoogle Scholar
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    Karmakar M. Thoracic paravertebral block. Anesthesiology. 2001;95(3):771–800.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Nelson L. Thaemert
    • 1
  1. 1.Department of Anaesthesiology, Perioperative, and Pain MedicineBrigham and Women’s HospitalBostonUSA

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