P-207 * Epidural Versus Paravertebral Analgesia in Thoracotomy Patients: A Randomized, Prospective Study

Raveglia, Federico; Rizzi, Alessandro; Mauro, P. Di; Moro, D; Leporati, A.; Cioffi, Ugo; Baisi, Alessandro

doi:10.1093/icvts/ivu167.207

Cited by 1 publication

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“…This protection also may be related to the systemic effect of local anesthetics, which may have an antithrombotic effect. Inadequate analgesia causes prolonged immobility, which is an additional risk factor for postoperative hypercoagulability [11] . In addition, perioperative pain is a major source of fear and anxiety in hospitalized patients.…”

Section: Acute Post-thoracotomy Painmentioning

confidence: 99%

Post-Thoracotomy Pain: Review Article

Gad-Allah¹,

Abdelfattah²,

Badawy³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Thoracotomy is a very painful surgical procedure that is used to get access into the pleural space, to the lungs, to the heart, to the esophagus or to get access to the thoracic aorta or anterior mediastinum. Objective: To study different modalities of treatment used for post thoracotomy pain control. Recent Findings: Inadequate post-thoracotomy analgesia enhances the postoperative stress response with deleterious effects on respiratory, cardiovascular, gastrointestinal, urinary, immune and coagulation systems. In addition to anxiety and increased risk of Post Thoracotomy Pain Syndrome (PTPS), which can interfere with normal life and may persist for years or even for life? Conclusion: Providing adequate post-thoracotomy analgesia can be challenging, as patients are often elderly or having multiple comorbidities. A multimodal approach is considered in managing post-thoracotomy pain starting with preemptive analgesia and cognitive behavioral modalities in addition to conventional multimodal systemic regimens as opioids, acetaminophen, NSAID, cyclooxygenase (COX)-2-specific inhibitors, gabapentin and pregabalin, steroids, IV lidocaine infusion, ketamine, and many regional analgesic modalities to avoid or decrease adverse effects of systemic regimens. These regional analgesic modalities include thoracic epidural blocks, thoracic paravertebral blocks, intrathecal opioid analgesia, serratus anterior plane blocks, intercostal nerve blocks, interscalene block, erector spinae block and interpleural block.

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Section: Acute Post-thoracotomy Painmentioning

confidence: 99%