Schmerztherapie nach thoraxchirurgischen Eingriffen

Abstract

The treatment of pain after thoracic surgery is a challenge and takes place in the individual clinics mostly according to clinic internal standards. It exists no currently valid S3 guideline for the treatment of acute perioperative and posttraumatic pain. For an effective pain treatment as well individual pain experience as the pain intensity of the various thoracic surgical procedures must be considered. Regular pain assessment with appropriate methods and their documentation form the basis for adequate and adapted pain therapy.There are a number of different pain therapy methods, non-medicamentous and drug-based methods, whose effectiveness is described in the literature partially different. For the treatment of acute postoperative pain after thoracic surgery, mainly drug-related procedures are used, except for physiotherapy as a non-medicamentous method. Increasingly, alternative procedures for the peridural catheter as a therapeutic gold standard in the treatment of pain after thoracic surgery are used. Their application can be integrated into a therapeutic algorithm.

Assessment and pathophysiology of pain in cardiac surgery

“…A thorough assessment requires selection of validated measurement tools, which are adjusted to perceptual abilities and allow the detection of pain and assessment of its intensity, as well as the efficiency of treatment. 17 , 19 , 96 Preferred scales, recognized by clinicians as the most precise evaluation tools, are based on self-assessment. 16 , 97 The scales most commonly used in the postoperative period include the verbal rating scale (VRS), NRS, VAS, and picture scales, eg, based on the representation of facial expressions ( Figure 2 ).…”

“…For the treatment of acute postoperative pain after thoracic surgery, mainly drug-related procedures are used, except for physiotherapy as a nonpharmacological method. 19 , 111 …”

“…An appropriate method of alleviating pain and observing the patient for the occurrence of complications associated with the administration of certain analgesics play a key role in postoperative pain control. 19 , 20 …”

Perioperatives Management

“…Hier möchte ich Ihnen besonders den CME-Artikel nahelegen. Hendrix et al [5] widmen sich in dem CME-Artikel der wichtigen Fragestellung der Schmerztherapie nach thoraxchirurgischen Eingriffen. Schmerzen nach thoraxchirurgischen Eingriffen gehören mit zu den stärksten postoperativen Perioperatives Management…”