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Pain treatment after thoracotomy: is it a special problem?
G M Salzer1, P Klingler, A Klingler
1Department of Thoracic Surgery, University Hospital, Innsbruck, Austria.
The Annals of Thoracic Surgery
|May 1, 1997
Summary
Contrary to common belief, posterolateral thoracotomy is less painful than median laparotomy. Patient-controlled analgesia effectively manages pain after thoracic or abdominal incisions.
Area of Science:
- Thoracic Surgery
- Pain Management
- Surgical Incisions
Background:
- Posterolateral thoracotomy is widely perceived as a highly painful surgical incision.
- Limited empirical data exist to substantiate the severity of pain associated with thoracotomy.
Purpose of the Study:
- To quantitatively compare the postoperative pain experience following posterolateral thoracotomy versus median laparotomy.
- To evaluate the efficacy of patient-controlled analgesia (PCA) in managing pain after these procedures.
Main Methods:
- A prospective study comparing 55 patients undergoing posterolateral thoracotomy with 30 patients undergoing median laparotomy.
- Postoperative pain was assessed using daily self-administered doses of analgesia via PCA for the first 4 days.
- The visual analog scale (VAS) was employed as a secondary measure of pain intensity.
Main Results:
- Analysis of PCA usage on postoperative day 1 and VAS scores for the first 2 days revealed a statistically significant difference.
- Results indicated that posterolateral thoracotomy was associated with less pain compared to median laparotomy.
- The findings challenge the prevailing notion of extreme pain after thoracotomy.
Conclusions:
- The common assumption that posterolateral thoracotomy is exceptionally painful is not supported by this study's findings.
- Specialized pain relief techniques may not be necessary for all post-thoracotomy patients.
- Patient-controlled analgesia is demonstrated to be sufficient for managing pain after major thoracic and abdominal surgical incisions.