Post-Thoracotomy Pain: Review Article | ||||
The Egyptian Journal of Hospital Medicine | ||||
Article 6, Volume 85, Issue 2, October 2021, Page 3519-3523 PDF (346.99 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejhm.2021.200580 | ||||
View on SCiNiTO | ||||
Authors | ||||
Asmaa Saad-Eldeen Farghaly Gad-Allah ; Khaled Abdelfattah Mohamed Abdelfattah; Fawzy Abbas Badawy; Abd El-Rahman Hasan Abd El-Rahman; Salah Ahmed Mohamed | ||||
Abstract | ||||
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. | ||||
Keywords | ||||
Post-thoracotomy pain; Systemic analgesic treatment; Regional analgesic modalities | ||||
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