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Post-thoracotomy spirometric lung function: the effect of analgesia. A review
J Richardson1, S Sabanathan, R Shah
1Department of Anaesthetics, Bradford Royal Infirmary, England.
The Journal of Cardiovascular Surgery
|July 21, 1999
Summary
Effective post-thoracotomy pain management significantly impacts pulmonary function recovery. Paravertebral analgesia best preserves lung function, highlighting the need for spirometric monitoring in chest surgery patients.
Area of Science:
- Thoracic Surgery
- Pain Management
- Pulmonary Function
Background:
- Post-thoracotomy pain can significantly impair lung function.
- Assessing the impact of pain management on pulmonary outcomes is crucial.
Purpose of the Study:
- To evaluate the efficacy of different post-thoracotomy pain management strategies on pulmonary function preservation.
- To compare analgesic regimens based on spirometric data.
Main Methods:
- Systematic review of prospective, randomized, controlled trials.
- Inclusion of studies on postero-lateral thoracotomy with perioperative spirometry.
- Analysis of mean postoperative percentage preservation of preoperative lung function.
Main Results:
- 55 studies and 1762 patients were reviewed.
- Paravertebral analgesia demonstrated the highest lung function preservation (~75% at 48 hours).
- Interpleural analgesia was least effective (~35% preservation at 48 hours).
Conclusions:
- Pain management choice critically affects postoperative pulmonary function after thoracotomy.
- Effective analgesia is essential for attenuating pulmonary dysfunction.
- Spirometric monitoring is vital for objective comparison of pain management techniques.