title: Post-thoracotomy analgesia.
abstract: The severity of postoperative pain after thoracotomy means that total analgesia cannot be achieved with a single method or agent without significant side-effects. Recent advances in our understanding of the mechanism of pain generation and maintenance mean that measures prior to surgery greatly affect the requirement for postoperative analgesia. We review the methods available for post-thoracotomy analgesia in the light of our knowledge of peripheral and central mechanisms of neuronal hypersensitivity. The combination of opiate premedication, preoperative non-steroidal anti-inflammatory drugs (NSAIDs), preincisional regional block and postoperative continuous paravertebral block together with NSAIDs may be the ideal combination for near total analgesia following thoracotomy.
authors.affiliation: Department of Thoracic Surgery, Bradford Royal Infirmary, UK.
authors.forename: J
authors.initials: J
authors.lastname: Eng
authors.forename: S
authors.initials: S
authors.lastname: Sabanathan
mesh_terms: D000698:Analgesia / Q000379:methods*; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006801:Humans; D009407:Nerve Block; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013908:Thoracotomy / Q000009:adverse effects*
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal