Preventing and Treating Pain after Thoracic Surgery

Gottschalk, Allan; Cohen, Steven P.; Yang, Stephen C.; Ochroch, E. Andrew; Warltier, David C.

doi:10.1097/00000542-200603000-00027

Cited by 307 publications

(216 citation statements)

References 66 publications

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“…1,2,8 However, reported incidence varies widely, as investigators did not use a standardized set of criteria to classify subjects as having post-thoracotomy pain. For example, some studies considered subjects to have PTPS based upon whether pain was present or absent, whereas others required a certain level of pain intensity in order to designate a subject as having PTPS.…”

Section: Incidencementioning

confidence: 99%

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Preventing Post‐Thoracotomy Pain Syndrome

Khelemsky

Noto

2012

Mount Sinai J Medicine

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This article provides a concise overview of post‐thoracotomy pain syndrome, describes anesthetic and surgical factors that have been investigated to reduce the incidence of the syndrome, and explores the effectiveness of various treatments for this condition. Although some interventions (both procedural and pharmacologic) have been investigated in both preventing and treating post‐thoracotomy pain syndrome, definitive studies are lacking and firm conclusions regarding the benefit of any intervention cannot be drawn. The problem is compounded further by our lack of understanding of the pathophysiologic mechanisms underlying the development of chronic pain after surgery. Going forward, it will be important to elucidate these mechanisms and conduct well‐designed trials involving novel therapeutic agents for both prevention and treatment of post‐thoracotomy pain syndrome. Mt Sinai J Med 79:133–139, 2012. © 2012 Mount Sinai School of Medicine

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Section: Incidencementioning

confidence: 99%

“…In the immediate perioperative period, inadequately controlled pain can prevent patients from taking large-volume breaths, leading to pulmonary complications such as atelectasis and pneumonia. 2,3 The International Association for the Study of Pain defines chronic post-thoracotomy pain as pain that recurs or persists along a thoracotomy…”

mentioning

confidence: 99%

Preventing Post‐Thoracotomy Pain Syndrome

Khelemsky

Noto

2012

Mount Sinai J Medicine

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“…In general, it is burning and stabbing pain with dysesthesia and thus shares many features of neuropathic pain (29). PTPS is increasingly acknowledged by anesthesiologists and surgeons alike (30).…”

Section: Chronic Post-thoracotomy Painmentioning

confidence: 99%

Postthoracotomy Pain Management Problems

Gerner

2008

Anesthesiology Clinics

219

130

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SynopsisPain after thoracotomy is very severe, probably the most severe pain experienced after surgery. It is also unique as this pain state has multiple implications, including respiratory failure due to splinting; inability to clear secretions by effective coughing, with resulting pneumonia; and facilitation of the often incapacitating chronic pain: the post-thoracotomy pain syndrome. Thoracic epidural analgesia has greatly improved the pain experience and its consequences and has been considered the 'gold standard' for pain management after thoracotomy. This view has recently been challenged by the use of paravertebral nerve blocks. Nevertheless, severe ipsilateral shoulder pain and the prevention of the post-thoracotomy pain syndrome remain the most important challenges for post-thoracotomy pain management.

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“…Oysa tramadole ilave olarak ketorolak trometaminin kullanıldığı sistemik analjezi uygulanması kolay ve hastalar tarafından kabul edilen bir analjezi tekniği olduğunu ve literatürde bildirilen yan etkiler olmadan iyi bir şekilde ağrıyı kestiğini bildirmişler-dir. Torakotomi sonrası ağrı tedavisi için sistemik ilaç uygulamasında sıklıkla opioid ajanlar, tramadol HCL, nonsteroid anti enflamatuar ajanlar ve/veya bu ilaçların kombinasyonları kullanılmaktadır (2,9,(14)(15)(16)(17)(18) . Tramadol analjezik etkinliğinin güçlü opioidlere yakın olması (16) , yan etkisinin, solunum baskılama riskinin azlığı toraks cerrahisi sonrası kullanımına yol açmıştır (17,18) .…”

Section: Materyal Ve Metodunclassified