Abstract

REDONDO GOMEZ, Zhachel; DIAZ MENDIONDO, Miosotis; PASCUAL VILLARDEFRANCOS, Haydee  and  GARCIA GARCIA, Dayné. Strategies and problems associated with postoperative analgesia after thoracotomy. Rev cuba anestesiol reanim [online]. 2013, vol.12, n.1, pp. 70-79. ISSN 1726-6718.

Background: thoracotomy is one of the most painful surgical incisions. The surgical exposure of the thoracic cavity causes damage to multiple structures in the nociceptive chest wall and cardiopulmonary viscera. There is a high incidence of chronic and acute postoperative pain that can delay the recovery and cause long-term disability. The prevention and treatment of post-thoracotomy pain is a challenge that may require a variety of surgeries and is of vital importance to minimize pulmonary complications. Objective: to show strategies for the prevention and treatment of this type of pain. Methods: a detailed review of the available literature in relation to evidence-based strategies for the prevention and treatment of post-thoracotomy pain was made. Results: the suboptimal treatment of post-thoracotomy pain has important implications, especially in patients with limited pulmonary reserve, being pulmonary dysfunction the most frequent and important one. The general principles for the treatment of post-thoracotomy pain and current techniques to deal with its control are shown. Conclusions: thoracic epidural analgesia is currently the standard analgesia after a thoracic surgery and in the absence of contraindications, all patients scheduled for this type of surgery should have been placed a preoperative thoracic epidural catheter.

Keywords : post-thoracotomy pain; thoracic epidural anaesthesia; thoracic paravertebral block; intercostal block; video-assisted thoracoscopy; posthoracotomy chronic pain syndrome.

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