The Effects of Three Different Analgesia Techniques on Long-Term Postthoracotomy Pain

Potential strategies for preventing chronic postoperative pain: a practical approach: Continuing Professional Development

“…In these surgeries, it has also been reported that epidural analgesia was able to reduce PPSP. 32,39,40 In a meta-analysis published in 2013, Andreae et al analyzed 23 clinical trials that included 1,090 patients followed for six months postoperatively and 441 patients followed for one year after surgery. The aim of these clinical trials was to evaluate the impact of epidural analgesia on the development of PPSP.…”

“…Dans ces chirurgies, il a aussi été démontré que l'analgésie péridurale permettait une réduction des DCPC. 32,39,40 Dans une méta-analyse parue en 2013, Andreae et coll. ont analysé 23 études cliniques qui incluaient 1 090 patients suivis durant six mois et 441 durant un an.…”

Preventing Post‐Thoracotomy Pain Syndrome

“…Detailed below are 2 randomized controlled trials that found that TEA reduces PTPS, and a prospective randomized trial that found that the timing of TEA (preoperative or postoperative) did not influence the incidence of PTPS.17. 26,27 Senturk et al conducted a randomized, prospective study involving 69 patients, which compared the effects of 3 different analgesia techniques on post-thoracotomy pain: (1) TEA initiated preoperatively (group pre-TEA), (2) TEA initiated postoperatively (group post-TEA), and (3) intravenous patient-controlled analgesia (group IV-PCA). In group pre-TEA (n = 28), a 10-mL bolus of a solution of bupivacaine 0.1% + 0.1 mg/mL morphine in saline was administered at least 30 minutes before anesthetic induction, followed by a 7-mL/hour infusion of the same solution during the operation.…”

“…The authors concluded that TEA initiated preoperatively is a preferable method in preventing acute and chronic post-thoracotomy pain. 26 Obata et al conducted a double-blinded study in which 70 patients were assigned to randomly receive continuous epidural block with mepivacaine 1.5% either 20 minutes prior to surgical incision (Pre group) or at the completion of surgery (Post group). Indomethacin suppositories (50 mg) were also given to patients upon request as supplemental analgesics.…”

Novel concepts of analgesia for post operative pain: Multimodal analgesia

“…17 The main goals of preventive analgesia are to decrease pain after tissue injury to prevent spinal sensitization & to reduce the inflammatory or chronic pain. 18 …”