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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
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Interpleural analgesia after thoracotomy.

F M Ferrante1, V W Chan, G R Arthur

  • 1Pain Treatment Service, Brigham and Women's Hospital, Boston, MA 02115.

Anesthesia and Analgesia
|January 1, 1991
PubMed
Summary
This summary is machine-generated.

Two-catheter interpleural analgesia significantly reduced opioid use after thoracotomy. Local anesthetic loss through chest drains and epinephrine

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Area of Science:

  • Anesthesiology
  • Thoracic Surgery
  • Pain Management

Background:

  • Interpleural analgesia is used for post-thoracotomy pain relief.
  • Factors influencing its efficacy require further investigation.

Purpose of the Study:

  • To evaluate the impact of epinephrine, thoracostomy drainage, and catheter placement on interpleural analgesia efficacy after thoracotomy.

Main Methods:

  • Twenty patients undergoing thoracotomy were randomized to receive single or dual interpleural catheters.
  • Local anesthetic (bupivacaine) with or without epinephrine was administered.
  • Bupivacaine levels in blood and drainage fluid were measured; pain scores and opioid demand were assessed.

Main Results:

  • Epinephrine did not affect analgesia levels.
  • 30-40% of bupivacaine was lost via thoracostomy drainage within 4 hours.
  • Dual-catheter placement significantly reduced opioid requirements after 8 hours.

Conclusions:

  • Significant local anesthetic loss occurs via thoracostomy drains.
  • Dual-catheter placement improves post-thoracotomy pain management.
  • Inadequate analgesia may stem from anesthetic loss and pleural space factors.