Acute postoperative pain in lung transplant recipients.
BACKGROUND
This retrospective study was designed to assess the quality of postoperative pain control and the facility of transition from epidural to oral analgesia in lung transplant recipients.


METHODS
After institutional review board approval, data were collected from the charts of all patients who underwent lung transplantation at our institution between 1998 and 2002. The study group consisted of the patients for whom an epidural was the first postoperative pain management modality. To serve as a control group we reviewed the charts of 30 patients, randomly selected over the same period, who underwent a thoracotomy for indications other than transplantation and who received postoperative epidural analgesia.


RESULTS
Eighty-three patients were available for analysis. Unilateral and bilateral lung transplant recipients had equivalent quality of pain control. However, lung transplant recipients had a lower incidence of adequate pain relief than patients undergoing thoracotomy for other indications (73% vs 87%, p < 0.05). Lung transplant recipients also had a higher incidence of epidural to oral analgesia transition failure (47% vs 20%, p < 0.01).


CONCLUSIONS
This is the first study to assess the quality of postoperative pain control and success of transition from epidural to oral analgesia in lung transplant recipients. Prospective studies are needed to assess the impact of our findings on patients' outcome.
Richard
Chloé
C
Department of Anesthesiology, Montreal University Medical Center, Hôpital Notre-Dame, Montreal, Canada.
Girard
François
F
Ferraro
Pasquale
P
Chouinard
Philippe
P
Boudreault
Daniel
D
Ruel
Monique
M
Choinière
Manon
M
Poirier
Charles
C
Girard
Dominique C
DC
D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local; D002045:Bupivacaine; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy*; D012189:Retrospective Studies; D013908:Thoracotomy
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002045:Bupivacaine