Timelog-Based Approach to Early Post-Thoracotomy Pain in Lung Cancer Surgery

Abstract

ostoperative pain is a determinant of quality of life and complication occurrence after thoracotomy. 1-3 Impaired chest wall integrity, rib fractures, intercostal neural damage and alteration of nociception are the main factors determining the intensity of pain. 1,2,4 Systemic analgesia and regional analgesia techniques can be utilized separately or as a combination treatment to provide adequate pain relief. Regional analgesia was frequently used at the last 20 years since its safety and efficacy was 39 Timelog-Based Approach to Early Post-Thoracotomy Pain in Lung Cancer Surgery A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Postoperative pain is a major concern about thoracotomy and acts a determinant of quality of life and complication occurrence. Here we sought to disctinctively assess the predictors of significant pain in the 1 st , 6 th , and 12 hours of elective lung cancer surgery. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Seventy American Society of Anesthesiologists (ASA) 1-3 patients who were performed posterolateral thoracotomy by the same surgical team were retrospectively recruited. Perception of pain was quantified by Visual Analogue Scale (VAS) and VAS scores of 1 st , 6 th and 12 th hours were recorded and a score of four or higher was identified as significant pain. Postoperative analgesia was provided either by thoracic epidural analgesia (TEA) with 0.1% bupivacaine or pethidine-based intravenous analgesia (IVA) in our sample population. R Re es su ul lt ts s: : Regarding demographic characteristics, there were almost no significant differences among groups with and without significant pain (Group Significant Pain, SP, and Group Tolerable Pain, TP; respectively) at the first 12 hours. Exceptions were the presence of higher rates of iatrogenic rib fracture (p=0.02) and operation related complications (p=0.046) in Group SP at 1 st and 6 th hours respectively. The frequency of patients treated with IVA was significantly higher in SP group at 1 st and 6 th hours but not at 12 th hour. C Co on nc cl lu us si io on n: : Type of analgesia was solely detected to be a persistent determinant of significant pain after lung cancer surgery. However, this was valid for only the first six hours.K Ke ey yw wo or rd ds s: : Analgesia, epidural; pain measurement; thoracotomy Ö ÖZ ZE ET T A Am ma aç ç: : Postoperatif ağrı torakotomiye ilişkin temel bir sorundur; ve sadece yaşam kalitesinde değil komplikasyon görülme sıklığında da belirleyici rol oynar. Bu çalışmada elektif akciğer kanser cerrahisi sonrası 1,6 ve 12. saatlerde kaydadeğer ağrıyı predikte eden etkenlerin birbirinden ayrı olarak tespit edilmesi hedeflenmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Aynı cerrahi ekip tarafından posterolateral torakotomi ile opere edilen 70 Amerikan Anesteziyoloji Derneği (ASA) 1-3 hastanın verileri retrospektif olarak incelendi. Vizüel Analog Skalası (VAS) ile sayısallaştırılan ağrı algısına dair skorların 1, 6 ve 12. saatlerdeki değerleri kaydedildi ve dört ve üzeri değerler ...