NDLI: Perioperative pain management after thoracotomy.

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Perioperative pain management after thoracotomy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Wenk, Manuel Schug, Stephan A.
Description	Country affiliation: Australia Author Affiliation: Wenk M ( Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, and Pharmacology and Anaesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.)
Abstract	PURPOSE OF REVIEW: Perioperative acute pain and the development of persistent pain after thoracotomy are major problems severely affecting health-related quality of life. This review examines and highlights recent strategies and advances in perioperative pain management in this field. RECENT FINDINGS: Despite the fact that thoracic epidural analgesia (TEA) is considered the 'gold standard' of perioperative care after thoracotomy, other local and regional techniques have emerged within recent years and seem to become valid alternatives to TEA. The use of continuous paravertebral blockade, in particular, may provide similar analgesia and fewer adverse effects than TEA. Multimodal systemic approaches, including the use of ketamine and gabapentinoids are being investigated as well as the effect of surgical techniques and adjuvant therapies such as transcutaneous electrical nerve stimulation on post-thoracotomy pain. SUMMARY: Even though thoracotomy is associated with significant postoperative complications, a growing understanding of the underlying pathophysiology and advances in multimodal pain therapy concepts in this specific group of patients are promising improved postoperative outcomes and potential reduction of the incidence of persistent pain.
File Format	HTM / HTML
ISSN	09527907
Issue Number	1
Volume Number	24
e-ISSN	14736500
Journal	Current Opinion in Anaesthesiology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2011-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Pain, Postoperative Therapy Thoracotomy Analgesia, Epidural Humans Nerve Block Adverse Effects Methods Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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