Pain treatment after thoracotomy: is it a special problem?
BACKGROUND
Although it is frequently stated in the literature that thoracotomy is one of the most painful operative incisions, few data supporting this view are available.


METHODS
Patients' postoperative pain experience can be assessed on the basis of their usage of patient-controlled analgesia. In a prospective trial the daily self-administered doses of analgesics in 55 patients within the first 4 days after posterolateral thoractomy were compared with those in 30 patients for the same number of days after median laparotomy. The visual analog scale was used as a second measure to evaluate postoperative pain.


RESULTS
On the basis of patient-controlled analgesia usage on the first postoperative day and the visual analog scale score for the first 2 days, a small but significant difference between the two patient groups was found which showed that thoracotomy is less painful than median laparotomy.


CONCLUSIONS
The common belief that posterolateral thoracotomy is a very painful operative access is not true. Therefore it is not necessary to use special techniques for postthoracotomy pain relief in these patients. Patient-controlled analgesia is sufficient for pain relief after major thoracic or abdominal incisions.
Salzer
G M
GM
Department of Thoracic Surgery, University Hospital, Innsbruck, Austria.
Klingler
P
P
Klingler
A
A
Unger
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000628:therapy*; D010892:Pirinitramide / Q000627:therapeutic use*; D013908:Thoracotomy
D000701:Analgesics, Opioid; D010892:Pirinitramide