Thoracotomy and thoracoscopy: postoperative pulmonary function, pain and chest wall complaints

Furrer, Markus; Rechsteiner, Renate; Eigenmann, Verena; Signer, C; Althaus, U; Ris, Hans‐Beat

doi:10.1016/s1010-7940(97)00105-x

Cited by 167 publications

(78 citation statements)

References 19 publications

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“…Two prospective trials found no differences in the incidence of PTPS when VATS was used compared with the classic posterolateral approach or the muscle-sparing posterolateral approach. 20,21 One retrospective study concluded that VATS reduced PTPS when compared with a muscle-sparing incision. 22 Other intraoperative surgical techniques that have been associated with reduced incidence of PTPS are harvesting an intercostal muscle flap, free dissection of intercostal nerves, and the use of intracostal sutures for closing the incision.…”

Section: Surgical Factorsmentioning

confidence: 99%

Preventing Post‐Thoracotomy Pain Syndrome

Khelemsky

Noto

2012

Mount Sinai J Medicine

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This article provides a concise overview of post‐thoracotomy pain syndrome, describes anesthetic and surgical factors that have been investigated to reduce the incidence of the syndrome, and explores the effectiveness of various treatments for this condition. Although some interventions (both procedural and pharmacologic) have been investigated in both preventing and treating post‐thoracotomy pain syndrome, definitive studies are lacking and firm conclusions regarding the benefit of any intervention cannot be drawn. The problem is compounded further by our lack of understanding of the pathophysiologic mechanisms underlying the development of chronic pain after surgery. Going forward, it will be important to elucidate these mechanisms and conduct well‐designed trials involving novel therapeutic agents for both prevention and treatment of post‐thoracotomy pain syndrome. Mt Sinai J Med 79:133–139, 2012. © 2012 Mount Sinai School of Medicine

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Section: Surgical Factorsmentioning

confidence: 99%

Preventing Post‐Thoracotomy Pain Syndrome

Khelemsky

Noto

2012

Mount Sinai J Medicine

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“…There is little consensus regarding the impact that the type of surgery has on the clinical outcome in terms of PTPS. Some studies showing there being no convincing difference and others claiming that video-assisted thoracoscopic procedures to be superior 8,[20][21][22][23] .…”

Section: Epidemiologymentioning

confidence: 99%

Post-Thoracotomy Pain Syndrome

Joseph¹,

Puttappa²,

Harney³

2012

Topics in Thoracic Surgery

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“…Effect of parecoxib combined with thoracic epidural analgesia on pain after thoracotomy to thoracotomy (2), patients undergoing thoracotomy and VATS alike continue to experience chronic pain at an alarmingly high incidence (3,4). Uncontrolled acute perioperative pain and related surgical stress responses are highly associated with poor outcomes after thoracotomy and predict the development of chronic pain (3,5).…”

Section: Introductionmentioning

confidence: 99%

Effect of parecoxib combined with thoracic epidural analgesia on pain after thoracotomy

Ling¹,

Fang²,

Zhang³

et al. 2016

J. Thorac. Dis.

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Background: Thoracotomy results in severe postoperative pain potentially leading to chronic pain. We investigated the potential benefits of intravenous parecoxib on postoperative analgesia combined with thoracic epidural analgesia (TEA).Methods: Eighty-six patients undergoing thoracic surgery were randomized into two groups. Patientcontrolled epidural analgesia (PCEA) was used until chest tubes were removed. Patients received parecoxib (group P) or placebo (group C) intravenously just 0.5 h before the operation and every 12 h after operation for 3 days. The intensity of pain was measured by using a visual analogue scale (VAS) and recorded at 2, 4, 8, 24, 48, 72 h after operation. The valid number of PCA, the side effects and the overall satisfaction to analgesic therapy in 72 h were recorded. Venous blood samples were taken before operation, the 1 st and 3 rd day after operation for plasma cortisol, adrenocorticotropic hormone (ACTH), interleukin-6 and tumor necrosis factor-α level. The occurrence of residual pain was recorded using telephone questionnaire 2 and 12 months after surgery.Results: Postoperative pain scores at rest and on coughing were significantly lower with the less valid count of PCA and greater patient satisfaction in group P (P<0.01). Adverse effect and the days fit for discharge were comparable between two groups. The cortisol levels in placebo group were higher than parecoxib group at T2. The level of ACTH both decreased in two groups after operation but it was significantly lower in group P than that in group C. There were no changes in plasma IL-6 and TNF-α levels before and after analgesia at T 1 and T 2 (P>0.05). The occurrence of residual pain were 25% and 51.2% separately in group P and C 3 months postoperatively (P<0.05).Conclusions: Intravenous parecoxib in multimodal analgesia improves postoperative analgesia provided by TEA, relieves stress response after thoracotomy, and may restrain the development of chronic pain.

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Thoracotomy and thoracoscopy: postoperative pulmonary function, pain and chest wall complaints

Cited by 167 publications

References 19 publications

Preventing Post‐Thoracotomy Pain Syndrome

Preventing Post‐Thoracotomy Pain Syndrome

Post-Thoracotomy Pain Syndrome

Effect of parecoxib combined with thoracic epidural analgesia on pain after thoracotomy

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