Efficacy of wound analgesia for controlling post-thoracotomy pain: a randomized double-blind study†

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Alfonso FiorelliMario Santini

Abstract

Continuous wound infusion of local anaesthetics has been successfully applied for postoperative pain control in several procedures but, surprisingly, it is underused in thoracic surgery. We aimed to investigate the effects of wound analgesia associated with systemic patient-controlled analgesia in patients undergoing lung cancer resection with muscle-sparing thoracotomy. Sixty consecutive patients undergoing lung cancer resection via standard muscle-sparing thoracotomy were randomized into two groups (wound analgesia and placebo groups). Bupivacaine in the wound group and free-saline solution in the placebo group were injected using a multiholed catheter connected to an elastomeric pump inserted at the end of operation between the pericostal sutures and the serratus muscle and removed 48 h after. The inter-group differences were assessed by the following criteria: (i) level of cytokines [IL-6, IL-10 and tumour necrosis factor-alpha (TNF-alpha)]; (ii) pain on a visual analogue scale at rest and after coughing; (iii) recovery of respiratory functions (flow expiratory volume in 1 s % and forced vital capacity %) and (iv) narcotic medication consumption at different time points of the postoperative course. Five out of a total of 60...Continue Reading

References

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Dec 11, 2003·The Journal of Thoracic and Cardiovascular Surgery·Robert DowlingAlan Dine
Aug 4, 2005·The Journal of Thoracic and Cardiovascular Surgery·Grayson H WheatleyJ Michael DiMaio
Mar 26, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ignacio GaruttiCarmen Benito
Sep 15, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alfonso FiorelliMario Santini
Mar 26, 2010·Annals of Internal Medicine·Kenneth F SchulzUNKNOWN CONSORT Group
May 21, 2011·Revista brasileira de anestesiologia·Maria Cristina Simões de AlmeidaAna Laura Colle Kauling
Jan 6, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alfonso FiorelliMario Santini
May 13, 2014·Best Practice & Research. Clinical Anaesthesiology·Christopher K MerrittRichard D Urman

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Citations

May 1, 2016·Interactive Cardiovascular and Thoracic Surgery·Andrea ImperatoriNicola Rotolo
Apr 7, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alfonso Fiorelli, Mario Santini
Sep 30, 2017·Head & Neck·Francesco Paolo CaroniaAlfonso Fiorelli
Feb 9, 2020·International Journal of Environmental Research and Public Health·Roberto CasconeAlfonso Fiorelli
Apr 7, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Zhihua Guo, Jianxing He
May 29, 2018·Mediators of Inflammation·Tábata Cristina do Carmo AlmeidaFernando Adami
Oct 28, 2017·Foot & Ankle International·Matthias BraitoRainer Biedermann
Apr 14, 2021·The Journal of Pain : Official Journal of the American Pain Society·Emine Ozgur BaymanTimothy J Brennan

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