Journal article
Acute and chronic pain syndromes after thoracic surgery
Surgical Clinics of North America, Vol.82(4), pp.849-865
2002
DOI: 10.1016/S0039-6109(02)00031-2
PMID: 12472133
Abstract
Pain is one of the most important considerations in the care of thoracic surgical patients. Failure in pain management is associated with increased mortality and morbidity. Acute pain management aspires to stop the painful stimuli before it is transferred to the CNS. The authors recommend (1) a thorough explanation of the operation and the expected outcome to the patient, (2) preoperative pulmonary rehabilitation for those with marginal lung function, (3) choosing the least painful surgical approach with acceptable exposure, (4) minimizing tissue trauma during surgery, (5) preemptive analgesia, and (6) early ambulation as prophylactic measures that should be employed during hospitalization. Good acute pain control should reduce the incidence of chronic pain. Mediansternotomy and VATS seem to be less acutely painful approaches than thoracotomy for most thoracic surgery. One should rule out recurrent malignancy as the etiology for chronic or recurrent pain. Opioids and NSAIDs are sufficient to produce optimal pain control in patients who undergo VATS and sternotomv. TEA is typically reserved for patients who have a thoracotomy. Opioid PCA can be used instead of-or after the discontinuation of-the epidural catheter. Chronic pain can be treated in many ways, and input from a pain clinic might be beneficial. The single best approach to chronic pain is to prevent it. This can be achieved by selecting the right incisional approach, instituting early physical therapy, and achieving optimal postoperative pain control.
Details
- Title: Subtitle
- Acute and chronic pain syndromes after thoracic surgery
- Creators
- Stephen R Hazelrigg - Division of Cardiothoracic Surgery, Southern Illinois University School of Medicine, 800 North Rutledge, Room D314, P.O. Box 19638, Springfield, IL 62794-9638, USAIbrahim B Cetindag - Division of Cardiothoracic Surgery, Southern Illinois University School of Medicine, 800 North Rutledge, Room D314, P.O. Box 19638, Springfield, IL 62794-9638, USAJames Fullerton - Division of General Surgery, Southern Illinois University School of Medicine, 800 North Rutledge, P.O. Box 19638, Springfield, IL 62794-9638, USA
- Resource Type
- Journal article
- Publication Details
- Surgical Clinics of North America, Vol.82(4), pp.849-865
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0039-6109(02)00031-2
- PMID
- 12472133
- ISSN
- 0039-6109
- eISSN
- 1558-3171
- Language
- English
- Date published
- 2002
- Academic Unit
- Surgery
- Record Identifier
- 9984051889502771
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