| Management of postthoracotomy pain: acute and chronic. | |
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MedLine Citation:
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PMID: 17004557 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Given the discomfort of thoracic surgical incisions, thoracic surgeons must understand and use contemporary multimodality pain treatments. Acute postthoracotomy pain not only causes psychologic distress to the patient but also has detrimental effects on pulmonary function and postoperative mobility, leading to increased morbidity. By choosing the most appropriate and least traumatic surgical incision, adhering to meticulous surgical techniques, and avoiding intercostal nerve injury or rib fractures, surgeons can minimize postoperative pain. Aggressive perioperative and postoperative pain management is best accomplished with use of an epidural anesthetic and covering breakthrough pain with an IV-PCA. Alternatively, an infusion system for continuous administration of local anesthetics directly in the subpleural plane, posterior to the intercostal incision, also provides excellent pain control. Again, use of an IV-PCA as adjuvant therapy is recommended. With careful planning, severe pain and its negative impact on thoracic surgical patients can be prevented. |
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Authors:
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Richard P Koehler; Robert J Keenan |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Thoracic surgery clinics Volume: 16 ISSN: 1547-4127 ISO Abbreviation: Thorac Surg Clin Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-09-28 Completed Date: 2006-11-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101198195 Medline TA: Thorac Surg Clin Country: United States |
Other Details:
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Languages: eng Pagination: 287-97 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular and Thoracic Surgery, Allegheny General Hospital, 320 East North Avenue, South Tower, 14th Floor, Pittsburgh, PA 15212, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Analgesia / methods Analgesics / therapeutic use Chronic Disease Humans Pain, Postoperative / etiology, physiopathology, therapy* Preoperative Care Thoracotomy / adverse effects*, methods |
| Chemical | |
Reg. No./Substance:
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0/Analgesics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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