Analgesic management after thoracotomy for decortication in children: a retrospective audit of 83 children managed with a paravertebral infusion‐based regime

ConclusionAnalgesic outcomes with this regimen appear to be very satisfactory. It compares favorably with an epidural‐based regimen.
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: Research Report Source Type: research

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Conditions:   Opioid Use;   Post-thoracotomy Pain Syndrome;   Local Anaesthetic Agent Overdose;   Local Anesthetic Complication;   Pain, Postoperative Intervention:   Procedure: Serratus anterior block Sponsor:   Indiana University Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
PATIENTS undergoing thoracic surgery require extensive surgical incisions or multiple intercostal port incisions and chest tube placements. These can result in severe postoperative pain and can lead to the development of pulmonary complications such as hypoxia, atelectasis, and pulmonary infections. Inadequate pain control can lead to post-thoracotomy pain syndrome, which may continue for years; thus, appropriate pain management is essential after thoracic surgery. For early postoperative pain management after thoracotomy, thoracic epidural analgesia (TEA) and/or paravertebral block (PVB) have been considered the gold standard.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Review Article Source Type: research
AbstractPurpose of ReviewThoracotomy surgeries are associated with severe pain in the post-operative period; inadequate control of this pain may give rise to pulmonary complications in the form of lung atelectasis and infection. Presently, regional analgesic techniques are the mainstay therapeutic measures suggested for the management of post-operative pain after thoracotomy.Recent FindingsSerratus anterior plane block has shown good pain relief after thoracotomy and thoracoscopy procedures in many clinical trials and case reports. It involves local anesthetic injection in a plane superficial or deep to the serratus anteri...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research
We present the case of a 51-year-old man with a history of recurrent lung cancer after left upper lobectomy who presented for an elective completion pneumonectomy via a bilateral anterior thoracotomy incision. At the completion of surgery, bilateral multilevel intercostal infiltration was performed with liposomal bupivacaine. Due to poorly controlled postoperative pain after extubation, a thoracic epidural was placed in the intensive care unit. An opioid-only infusion was started and transitioned to a local anesthetic–based infusion on postoperative day 2. This case report represents a novel stepwise approach of thor...
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
There is a growing interest in minimally invasive and transcatheter mitral surgery to treat degenerative mitral disease. One such technique entails the use of sternal sparing mini-thoracotomy and transcatheter beating heart targeted NeoChord resuspension under echo guidance (NeoChord DS1000, St. Louis Park, MN).1,2 However, the procedure does require a mini-thoracotomy, which can result in significant postoperative pain.3 As such, we performed serratus anterior plane block (SAPB) as part of a multimodal pain management strategy in 3 consecutive patients undergoing minimally invasive NeoChord mitral valve repair.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Background: Appropriate postoperative pain management can improve outcomes in patients with esophageal cancer (EC). Objective: To compare different combinations of anesthesia and analgesia techniques in patients with EC undergoing open thoracotomy. Methods: This randomized, controlled, open-label trial enrolled 100 patients with EC (aged 40–65 years; American Society of Anesthesiologists [ASA] grade I/II) receiving elective surgery at Jiangsu Province Hospital (China) between July 2016 and December 2017. Patients were randomized to 4 groups (n = 25 per group): total intravenous general anesthesia plus pat...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
Purpose of review Guidelines for enhanced recovery after surgery (ERAS) have recently been published for lung surgery. Although some of the recommendations are generic or focused on anesthetic and nursing care, other recommendations are more specific to a thoracic surgeon's practice. The present review concentrates on the surgical approach, optimal chest drain management, and the importance of early mobilization. Recent findings Most lung cancer resections are still performed via an open thoracotomy approach. If a thoracotomy is to be used, a muscle-sparing approach may result in reduced pain and better postoperative ...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: THORACIC ANESTHESIA: Edited by Albert C. Perrino Jr Source Type: research
CONCLUSIONS: Perioperative intravenous ketamine probably reduces postoperative analgesic consumption and pain intensity. Results were consistent in different operation types or timing of ketamine administration, with larger and smaller studies, and by higher and lower pain intensity. CNS adverse events were little different with ketamine or control. Perioperative intravenous ketamine probably reduces postoperative nausea and vomiting by a small extent, of arguable clinical relevance. PMID: 30570761 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
This study aimed to compare patient-controlled paravertebral analgesia (PCPA) and intravenous patient-controlled analgesia (IVPCA) in terms of analgesic efficiency, respiratory function, and adverse effects after video-assisted thoracoscopic surgery (VATS) lobectomy. Patients and methods: The prospective randomized trial study was carried out on 60 patients who underwent VATS lobectomy (randomly allocated 30 patients in each group). In the PCPA group, an initial dose of 0.3 mL/kg of 0.125% bupivacaine with fentanyl 2 µg/mL was administered, followed by a 3 mL/h continuous infusion with patient-controlled analgesi...
Source: Local and Regional Anesthesia - Category: Anesthesiology Tags: Local Reg Anesth Source Type: research
Thoracotomy is a procedure that causes severe pain as a result of muscle incision, retraction of the ribs, and damage to the intercostal nerves. Postoperative analgesia management is very important for respiratory functions, and successful pain management reduces postoperative complications and length of hospital stay.1 A variety of procedures have been described for the first-step treatment of thoracic analgesia, including intercostal nerve blocks, thoracic epidural analgesia (TEA), and thoracic paravertebral blocks.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
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