Pain and Physical Function Are Similar Following Axillary, Muscle-Sparing vs Posterolateral Thoracotomy

Ochroch, E. Andrew; Gottschalk, Alan; Augoustides, John; Aukburg, Stanley J.; Kaiser, Larry R.; Shrager, Joseph B.

doi:10.1378/chest.128.4.2664

Cited by 50 publications

(27 citation statements)

References 22 publications

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“…Even muscle-sparing incisions appear to have no major advantage over posterolateral incisions (45). Overall, variation in surgical techniques has not been shown to reduce subsequent pain (46).…”

Section: Mechanism Of Post-thoracotomy Painmentioning

confidence: 99%

Postthoracotomy Pain Management Problems

Gerner

2008

Anesthesiology Clinics

227

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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Section: Mechanism Of Post-thoracotomy Painmentioning

confidence: 99%

Postthoracotomy Pain Management Problems

Gerner

2008

Anesthesiology Clinics

227

130

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“…Conversely, in another prospective study designed to measure the pre-emptive effect of thoracic epidural analgesia, there was no difference in chronic pain incidence when compared axillary muscle-sparing thoracotomy vs. posterolateral thoracotomy (Ochroch et al, 2005).…”

Section: Pre-emptive Analgesiamentioning

confidence: 87%

Chest Wall Paraesthesia After Thoracic Surgery

González¹,

Castro²,

Candela³

2012

Paresthesia

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“…A popular approach is the axillary muscle-sparing incision, the skin incision for which extends vertically downwards from the axilla with obvious cosmetic advantages. Although muscle sparing incisions were initially reported to produce less peri-operative pain [51][52][53] most studies have not found this reduction in peri-operative pain [54,55]. Muscle-sparing incisions may result in less chronic post-thoracotomy pain [56].…”

Section: Muscle-sparing Incisionmentioning

confidence: 99%

“…Muscle-sparing incisions may result in less chronic post-thoracotomy pain [56]. Wider rib retraction is frequently required for muscle sparing thoracotomies to compensate for the reduced field of view [55]. Wider retraction may increase the risk of rib fractures, distraction of the posterior costovertebral joints and damage to the intercostal nerves, all of which can increase post-thoracotomy pain.…”

Section: Muscle-sparing Incisionmentioning

confidence: 99%