The role of intercostal nerve preservation in acute pain control after thoracotomy
OBJECTIVE: To evaluate whether the acute pain experienced during in-hospital recovery from thoracotomy can be effectively reduced by the use of intraoperative measures (dissection of the neurovascular bundle prior to the positioning of the Finochietto retractor and preservation of the intercostal n...
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Sociedade Brasileira de Pneumologia e Tisiologia
2014-04-01
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doaj-02e1fe2ef2b6403eb180df3569361ce52020-11-24T23:10:01ZengSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia1806-37562014-04-0140216417010.1590/S1806-37132014000200010S1806-37132014000200164The role of intercostal nerve preservation in acute pain control after thoracotomyMarco Aurélio Marchetti-FilhoLuiz Eduardo Villaça LeãoAltair da Silva Costa-JuniorOBJECTIVE: To evaluate whether the acute pain experienced during in-hospital recovery from thoracotomy can be effectively reduced by the use of intraoperative measures (dissection of the neurovascular bundle prior to the positioning of the Finochietto retractor and preservation of the intercostal nerve during closure). METHODS: We selected 40 patients who were candidates for elective thoracotomy in the Thoracic Surgery Department of the Federal University of São Paulo/Paulista School of Medicine, in the city of São Paulo, Brazil. The patients were randomized into two groups: conventional thoracotomy (CT, n = 20) and neurovascular bundle preservation (NBP, n = 20). All of the patients underwent thoracic epidural anesthesia and muscle-sparing thoracotomy. Pain intensity was assessed with a visual analog scale on postoperative days 1, 3, and 5, as well as by monitoring patient requests for/consumption of analgesics. RESULTS: On postoperative day 5, the self-reported pain intensity was significantly lower in the NBP group than in the CT group (visual analog scale score, 1.50 vs. 3.29; p = 0.04). No significant differences were found between the groups regarding the number of requests for/consumption of analgesics. CONCLUSIONS: In patients undergoing thoracotomy, protecting the neurovascular bundle prior to positioning the retractor and preserving the intercostal nerve during closure can minimize pain during in-hospital recovery.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132014000200164&lng=en&tlng=enDor pós-operatóriaAnalgesiaToracotomia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marco Aurélio Marchetti-Filho Luiz Eduardo Villaça Leão Altair da Silva Costa-Junior |
spellingShingle |
Marco Aurélio Marchetti-Filho Luiz Eduardo Villaça Leão Altair da Silva Costa-Junior The role of intercostal nerve preservation in acute pain control after thoracotomy Jornal Brasileiro de Pneumologia Dor pós-operatória Analgesia Toracotomia |
author_facet |
Marco Aurélio Marchetti-Filho Luiz Eduardo Villaça Leão Altair da Silva Costa-Junior |
author_sort |
Marco Aurélio Marchetti-Filho |
title |
The role of intercostal nerve preservation in acute pain control after thoracotomy |
title_short |
The role of intercostal nerve preservation in acute pain control after thoracotomy |
title_full |
The role of intercostal nerve preservation in acute pain control after thoracotomy |
title_fullStr |
The role of intercostal nerve preservation in acute pain control after thoracotomy |
title_full_unstemmed |
The role of intercostal nerve preservation in acute pain control after thoracotomy |
title_sort |
role of intercostal nerve preservation in acute pain control after thoracotomy |
publisher |
Sociedade Brasileira de Pneumologia e Tisiologia |
series |
Jornal Brasileiro de Pneumologia |
issn |
1806-3756 |
publishDate |
2014-04-01 |
description |
OBJECTIVE: To evaluate whether the acute pain experienced during in-hospital recovery from thoracotomy can be effectively reduced by the use of intraoperative measures (dissection of the neurovascular bundle prior to the positioning of the Finochietto retractor and preservation of the intercostal nerve during closure). METHODS: We selected 40 patients who were candidates for elective thoracotomy in the Thoracic Surgery Department of the Federal University of São Paulo/Paulista School of Medicine, in the city of São Paulo, Brazil. The patients were randomized into two groups: conventional thoracotomy (CT, n = 20) and neurovascular bundle preservation (NBP, n = 20). All of the patients underwent thoracic epidural anesthesia and muscle-sparing thoracotomy. Pain intensity was assessed with a visual analog scale on postoperative days 1, 3, and 5, as well as by monitoring patient requests for/consumption of analgesics. RESULTS: On postoperative day 5, the self-reported pain intensity was significantly lower in the NBP group than in the CT group (visual analog scale score, 1.50 vs. 3.29; p = 0.04). No significant differences were found between the groups regarding the number of requests for/consumption of analgesics. CONCLUSIONS: In patients undergoing thoracotomy, protecting the neurovascular bundle prior to positioning the retractor and preserving the intercostal nerve during closure can minimize pain during in-hospital recovery. |
topic |
Dor pós-operatória Analgesia Toracotomia |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132014000200164&lng=en&tlng=en |
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