title: Acute postoperative pain in lung transplant recipients.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Montreal University Medical Center, Hôpital Notre-Dame, Montreal, Canada.
authors.forename: Chloé
authors.initials: C
authors.lastname: Richard
authors.forename: François
authors.initials: F
authors.lastname: Girard
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ferraro
authors.forename: Philippe
authors.initials: P
authors.lastname: Chouinard
authors.forename: Daniel
authors.initials: D
authors.lastname: Boudreault
authors.forename: Monique
authors.initials: M
authors.lastname: Ruel
authors.forename: Manon
authors.initials: M
authors.lastname: Choinière
authors.forename: Charles
authors.initials: C
authors.lastname: Poirier
authors.forename: Dominique C
authors.initials: DC
authors.lastname: Girard
mesh_terms: 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
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002045:Bupivacaine