title: Application of Continuous Wound-Infusion Catheters in Lung Transplantation: A Retrospective Data Analysis.
abstract: BackgroundLung transplantation is the only treatment option for many patients with end-stage pulmonary disease. Therefore, postthoracotomy pain therapy is of vital interest. Thoracic epidural analgesia (EPI) is the "gold standard" for postthoracotomy pain, but especially in lung transplantation contraindications, and potential infectious complications limit its advantages. Under these circumstances surgically placed postthoracotomy catheter-assisted continuous paravertebral intercostal nerve block (PVB) could be of advantage.MethodsWe performed a retrospective cohort study of patients who underwent lung transplantation between 2005 and 2012. Groups were defined according to the type of postoperative pain therapy: PVB, EPI, and SYS (systemic analgesia). Total 44 patients were eligible.ResultsPostoperative opioid requirement of the PVB and EPI group was comparable and less than that of the SYS group. Patients of the PVB group were weaned earlier from mechanical ventilation after lung transplantation.ConclusionThe potency of postoperative pain therapy of EPI and PVB seemed to be comparable and superior to SYS. Considering the risks and benefits, PVB could be a better choice than EPI for postthoracotomy pain therapy, especially in lung transplantation.
authors.affiliation: Department of Anesthesiology, University Giessen, Giessen, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Lenz
authors.affiliation: Department of General and Thoracic Surgery, Klinikum Worms, Worms, Germany.|Department of General and Thoracic Surgery, University Giessen, Giessen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Hirschburger
authors.affiliation: Department of Anesthesiology, University Giessen, Giessen, Germany.|Department of Medical Informatics, University Oldenburg, Oldenburg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Roehrig
authors.affiliation: Department of Anesthesiology, University Giessen, Giessen, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Menges
authors.affiliation: Department of Anesthesiology, University Giessen, Giessen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Mueller
authors.affiliation: Department of General and Thoracic Surgery, University Giessen, Giessen, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Padberg
authors.affiliation: Department of Anesthesiology, University Giessen, Giessen, Germany.
authors.forename: Valesco
authors.initials: V
authors.lastname: Mann
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002408:Catheters, Indwelling; D006801:Humans; D007367:Intercostal Nerves; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D009407:Nerve Block / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D013908:Thoracotomy / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D015300:Ventilator Weaning
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local