Abstract
Thoracotomy is among the most painful of all surgical incisions. Necessary motions of respiration exacerbate that pain. It is no surprise that the most frequent perioperative complications following thoracic surgery are pulmonary in nature, or that good control of thoracotomy pain improves pulmonary outcome.
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Selected References
Cheng JK, Ji RR. Intracellular signaling in primary sensory neurons and persistent pain. Neurochem Res. 2008;33(10):1970–8.
Ji RR, Kohno T, Moore KA, Woolf CJ. Central sensitization and LTP: do pain and memory share similar mechanisms? Trends Neurosci. 2003;26(12):696–705.
Burgess FW, Anderson DM, Colonna D, Sborov MJ, Cavanaugh DG. Ipsilateral shoulder pain following thoracic surgery. Anesthesiology. 1993;78(2):365–8.
Danelli G, Berti M, Casati A, et al. Ipsilateral shoulder pain after thoracotomy surgery: a prospective, randomized, double-blind, placebo-controlled evaluation of the efficacy of infiltrating the phrenic nerve with 0.2%wt/vol ropivacaine. Eur J Anaesthesiol. 2007;24(7):596–601.
Boisseau N, Rabary O, Padovani B, et al. Improvement of “dynamic analgesia” does not decrease atelectasis after thoracotomy. Br J Anaesth. 2001;87(4):564–9.
Popping DM, Zahn PK, Van Aken HK, Dasch B, Boche R, Pogatzki-Zahn EM. Effectiveness and safety of postoperative pain management: a survey of 18 925 consecutive patients between 1998 and 2006 (2nd revision): a database analysis of prospectively raised data. Br J Anaesth. 2008;101(6):832–40.
Groeben H. Epidural anesthesia and pulmonary function. J Anesth. 2006;20(4):290–9.
Goertz AW, Seeling W, Heinrich H, Lindner KH, Schirmer U. Influence of high thoracic epidural anesthesia on left ventricular contractility assessed using the end-systolic pressure-length relationship. Acta Anaesthesiol Scand. 1993;37(1):38–44.
Oka T, Ozawa Y, Ohkubo Y. Thoracic epidural bupivacaine attenuates supraventricular tachyarrhythmias after pulmonary resection. Anesth Analg. 2001;93(2):253–9.
Jideus L, Joachimsson PO, Stridsberg M, et al. Thoracic epidural anesthesia does not influence the occurrence of postoperative sustained atrial fibrillation. Ann Thorac Surg. 2001;72(1):65–71.
Dernedde M, Stadler M, Taviaux N, Boogaerts JG. Postoperative patient-controlled thoracic epidural analgesia: importance of dose compared to volume or concentration. Anaesth Intensive Care. 2008;36(6):814–21.
De CG, Congedo E, Mascia A, Adducci E, Lai C, Aceto P. Epidural infusion of levobupivacaine and sufentanil following thoracotomy. Anaesthesia. 2007;62(10):994–9.
Romer HC, Russell GN. A survey of the practice of thoracic epidural analgesia in the United Kingdom. Anaesthesia. 1998;53(10):1016–22.
Hogan QH. Epidural anatomy examined by cryomicrotome section. Influence of age, vertebral level, and disease. Reg Anesth. 1996;21(5):395–406.
Horlocker TT. ASA Newsletter. ASA Newsletter Jan 4 2001.
Ballantyne JC, Carr DB, deFerranti S, et al. The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg. 1998;86(3):598–612.
Liu SS, Wu CL. Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth Analg. 2007;104(3):689–702.
Popping DM, Elia N, Marret E, Remy C, Tramer MR. Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis. Arch Surg. 2008;143(10):990–9.
Polaner DM, Kimball WR, Fratacci MD, Wain JC, Zapol WM. Thoracic epidural anesthesia increases diaphragmatic shortening after thoracotomy in the awake lamb. Anesthesiology. 1993;79(4):808–16.
Beattie WS, Badner NH, Choi P. Epidural analgesia reduces postoperative myocardial infarction: a meta-analysis. Anesth Analg. 2001;93(4):853–8.
Ng JM, Hartigan PM. Pain management strategies for patients undergoing extrapleural pneumonectomy. Thorac Surg Clin. 2004;14(4):585–92.
Further Suggested Reading
Clementi A, Carli F. The physiological effects of thoracic epidural anesthesia and analgesia on the cardiovascular, respiratory, and gastrointestinal systems. Minerva Anestesiol. 2008;74:549–63.
DeCosmo G, Aceto P, Gualtieri E, Congedo E. Analgesia in thoracic surgery: review. Minerva Anestesiol. 2009;75:393–400.
Joshi G, Bonnet F, Shah R, et al. A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia. Anesth Analg. 2008;107:1026–40.
Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy. American society of regional anesthesia and pain medicine evidence-based guidelines (3rd edition). Reg Anesth Pain Med. 2010;35:64–101.
Breivik H, Bang U, Jalonen J, et al. Nordic guidelines for neuraxial blocks in disturbed haemostasis from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand. 2010;54:16–41.
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Gerner, P., Gerner, P., Hartigan, P.M. (2012). Acute Postoperative Pain Control Following Thoracic Surgery. In: Hartigan, P. (eds) Practical Handbook of Thoracic Anesthesia. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-88493-6_37
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DOI: https://doi.org/10.1007/978-0-387-88493-6_37
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