Thoracic Epidural Morphine for Postoperative Analgesia after Hemiclamshell Incision in Castleman Disease

Abstract

<p class="MsoNormal"> <span lang="EN-US" style="font-family:Verdana;">The hemiclamshell incision is a valid but infrequent surgical alternative for the resection of tumors from mediastinum. This point makes this approach impossible to be studied under a randomized controlled trial. The triple association of thoracotomy, sternotomy and cervicothomy makes the hemiclamshell approach a high intensity postoperative pain sur</span><span lang="EN-US" style="font-family:Verdana;">gery. However, there is no published data on this topic, and the reviewed articles only mention the analgesic regimens as a secondary point. Indeed, no author defines the best epidural drugs mixture for the patients.</span><span lang="EN-US"> </span><span lang="EN-US" style="font-family:Verdana;">Multimodal analgesic regimen based on regional anesthesia should be used. Based on the recent advances on spinal opioids, morphine could be a good choice as epidural coadjutant to local anesthetics for hemiclamshell incision.</span><span lang="EN-US"><o:p></o:p></span> </p