Incidence of post-thoracotomy pain: a comparison between total intravenous anaesthesia and inhalation anaesthesia

Song, Jae-Kwan; Shin, Jin Woo; Lee, Eun‐Ho; Choi, Dae Ki; Bang, Ji‐Yeon; Chin, Ji Hyun; Choi, In‐Cheol

doi:10.1093/ejcts/ezr133

Cited by 59 publications

(39 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A total of nine trials reported pain intensity at or around 24 h postsurgery, in which 595 patients received propofol anaesthesia, while 586 had inhalational anaesthesia [10,11,18,19,21,22,25,28,29]. Overall, compared with inhalational anaesthetics, patients who received propofol reported significantly lower pain scores 24 h postsurgery (Hedge's g (95% CI) À0.134 (À0.248 to À0.021) (p = 0.021) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In the studies which reported 2-h or 24-h pain scores, only three investigated morphine-equivalent consumption at or around 24 h postsurgery [18,21,29]. A total of 248 patients received propofol, and 248 patients received inhalational anaesthesia.…”

Section: Resultsmentioning

confidence: 99%

“…The effects of these analgesics are likely to negate the effects of propofol, which appear to be small. In addition to acute postoperative pain, longer-term pain relief has been observed in a clinical trial showing that the incidence of postoperative and newly developed pain was reduced 6 months after thoracotomy using propofol compared with inhalation anaesthesia [29]. Another study in breast cancer surgery also found that propofol was associated with a reduced incidence of chronic postoperative pain [36].…”

Section: Discussionmentioning

confidence: 98%

See 2 more Smart Citations

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

et al. 2016

View full text Add to dashboard Cite

SummaryPropofol is used both for induction and maintenance of anaesthesia. Recent evidence shows that propofol has analgesic properties. This meta-analysis evaluated differences in postoperative analgesia between general anaesthetic maintenance with intravenous propofol and inhalational anaesthetics. Fourteen trials met inclusion criteria and were included. Our outcomes were pain scores 2 and 24 h after surgery. No significant difference in pain scores was found at 2 h after surgery (Hedge's g (95% CI) À0.120 (À0.415-0.175) (p = 0.425). Propofol was associated with a statistically significant, albeit marginal, reduction in pain scores 24 h after surgery (Hedge's g (95% CI) À0.134 (À0.248 to À0.021) (p = 0.021). Data were insufficient to allow a meaningful analysis regarding 24-h morphine-equivalent consumption. Propofol was associated with reduced postoperative nausea and vomiting (relative risk (95%CI) 0.446 (0.304-0.656) (p < 0.0001). In conclusion, this meta-analysis suggests that propofol improves postoperative analgesia compared with inhalational anaesthesia 24 h after surgery, with a lower incidence of nausea and vomiting.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

et al. 2016

View full text Add to dashboard Cite

show abstract

“…18 The use of nitrous oxide has been shown to decrease the risk of chronic postsurgical pain after major noncardiac surgery, 19 and total intravenous anesthesia with propofol and remifentanil may reduce the incidence of chronic postsurgical pain after thoracotomy when compared with inhalation anesthesia. 20 This is an area of anesthesiology that requires further study.…”

Section: Does the Type Of Anesthesia Matter?mentioning

confidence: 99%

“…18 Il a été démontré que l'utilisation de protoxyde d'azote réduisait le risque de douleur chronique postchirurgicale après une chirurgie non cardiaque majeure, et l'anesthésie intraveineuse totale réalisée avec du propofol et du rémifentanil pourrait réduire l'incidence de douleur chronique postchirurgicale après une thoracotomie comparativement à une anesthésie par inhalation. 20 Ce domaine de l'anesthésiologie nécessite des études supplémentaires.…”

Section: Le Rôle De L'analgésie Multimodaleunclassified

Why anesthesiologists need to care about the way chronic pain is managed

Clark

Spanswick

2013

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

A systematic review of therapeutic interventions to reduce acute and chronic post‐surgical pain after amputation, thoracotomy or mastectomy

Humble

Dalton

2014

European Journal of Pain

186

150

View full text Add to dashboard Cite

BackgroundPerioperative neuropathic pain is under-recognized and often undertreated. Chronic pain may develop after any routine surgery, but it can have a far greater incidence after amputation, thoracotomy or mastectomy. The peak noxious barrage due to the neural trauma associated with these operations may be reduced in the perioperative period with the potential to reduce the risk of chronic pain.Databases and data treatmentA systematic review of the evidence for perioperative interventions reducing acute and chronic pain associated with amputation, mastectomy or thoracotomy.ResultsThirty-two randomized controlled trials met the inclusion criteria. Gabapentinoids reduced pain after mastectomy, but a single dose was ineffective for thoracotomy patients who had an epidural. Gabapentinoids were ineffective for vascular amputees with pre-existing chronic pain. Venlafaxine was associated with less chronic pain after mastectomy. Intravenous and topical lidocaine and perioperative EMLA (eutectic mixture of local anaesthetic) cream reduced the incidence of chronic pain after mastectomy, whereas local anaesthetic infiltration appeared ineffective. The majority of the trials investigating regional analgesia found it to be beneficial for chronic symptoms. Ketamine and intercostal cryoanalgesia offered no reduction in chronic pain. Total intravenous anaesthesia (TIVA) reduced the incidence of post-thoracotomy pain in one study, whereas high-dose remifentanil exacerbated chronic pain in another.ConclusionsAppropriate dose regimes of gabapentinoids, antidepressants, local anaesthetics and regional anaesthesia may potentially reduce the severity of both acute and chronic pain for patients. Ketamine was not effective at reducing chronic pain. Intercostal cryoanalgesia was not effective and has the potential to increase the risk of chronic pain. TIVA may be beneficial but the effects of opioids are unclear.

show abstract

Incidence of post-thoracotomy pain: a comparison between total intravenous anaesthesia and inhalation anaesthesia

Abstract: TIVA with propofol and remifentanil may reduce the incidence of CPTS at 3 and 6 months.

Cited by 59 publications

References 22 publications

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

Why anesthesiologists need to care about the way chronic pain is managed

A systematic review of therapeutic interventions to reduce acute and chronic post‐surgical pain after amputation, thoracotomy or mastectomy

Contact Info

Product

Resources

About