The authors compare the efficacy of epidural morphine analgesia with continuous intercostal extrapleural block using bupivacaine 0.5% after thoracotomy. They affirm that antalgic treatment in thoracotomised patients is the most important factor in preventing the onset of major complications that may negatively influence the results of surgery. The efficacy of the analgesic techniques examined was evaluated using El-Baz's visual analogic scale of pain, through the analysis of spirometric values and on the incidence of postoperative complications. The authors demonstrate that the extrapleural continuous nerve block is a reliable method of post-thoracotomic analgesia.
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Cureus
December 2024
Anesthesiology, Rhode Island Hospital, Brown University, Providence, USA.
Acute pain service was consulted for acute pain management in a 40-year-old male who had sustained multiple bilateral rib fractures following a fall injury. In addition to the rib fractures, the patient had also experienced injuries to his lungs and spinal column, both of which required surgeries. Considering the significant nature of pain due to his rib fractures, a multimodal pain management approach that included both pharmacological and non-pharmacological strategies was utilized.
View Article and Find Full Text PDFTransl Pediatr
December 2024
Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Background And Objective: Pectus excavatum is a common congenital chest wall abnormality characterized by a concave appearance of the chest, and minimally invasive repair of pectus excavatum (MIRPE) is the surgical treatment of choice. A rapidly growing field of research is pain management in children undergoing MIRPE, with many shifts in practice occurring over the last decade. The primary objectives of this narrative review are to describe current methods of perioperative pain management and the development of enhanced recovery after surgery (ERAS) to improve the experience of patients undergoing MIRPE.
View Article and Find Full Text PDFVet Surg
January 2025
College of Veterinary Medicine, Hixson- Lied Small Animal Hospital, Iowa State University, Ames, Iowa, USA.
Objective: To report the technique and outcomes of utilizing chest wall lift to perform thoracoscopic surgery in two cats.
Study Design: Short case series.
Animals: Client-owned cats (n = 2).
J Clin Med
December 2024
Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, Aberdeen AB24 3UE, UK.
Thoracic surgery is associated with significant postoperative pain, which can hinder recovery and elevate morbidity risks. Traditionally, epidural anesthesia has been the cornerstone for pain management, but its drawbacks including technical challenges, side effects, and complications necessitate exploring alternative methods. This narrative review examined recent advances in perioperative analgesic strategies in thoracic surgery, focusing on regional anesthetic techniques like paravertebral blocks (PVBs), erector spinae plane blocks (ESPBs), intercostal blocks, and serratus anterior blocks.
View Article and Find Full Text PDFCureus
December 2024
Student Research Unit, School of Medicine, 21 September University, Sana'a, YEM.
Penetrating thoracic injuries, especially those affecting cardiac structures, are rare but can be life-threatening, requiring urgent medical care. Right atrium injuries pose significant risks, including rapid blood loss, cardiac tamponade, hemodynamic instability, and, subsequently, potential death. We report the case of a 24-year-old male patient with stab wounds leading to a right-sided chest penetration three hours prior to presentation.
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