Postoperative analgesia after thoracotomies Torakotomilerde postoperatif analjezi uygulamalarimiz
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.14, sa.3, ss.98-103, 2008 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 14 Sayı: 3
- Basım Tarihi: 2008
- Dergi Adı: Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.98-103
- Anahtar Kelimeler: Multimodal analgesia, Postoperative anlagesia, Thoracic epidural analgesia, Thoracotomy
- Kırklareli Üniversitesi Adresli: Hayır
Özet
Aim: Efficient analgesia after thoracotomies improves functional recovery and facilitates early mobilization, reduces postoperative complications. In this retrospective study, we aimed to investigate the effetcs of different analgesic therapies on pain control after thoracotomy; and also to evaluate the correlation between postoperative analgesic protocol and complications. Material and Methods: Patients undergoing thoracotomy from January to December of 2007 were included into the study. Types of surgical incision (anterior, posterior, posterolateral or lateral) and resection (lobectomy, pneumonectomy or miscellaneous) for each patient were recorded. Analgesic protocols were determined as intercostal block (ICB), thoracic epidural analgesia (TEA), ICB + i.v. opioid or paracetamol. Non-steroidal anti-inflammatory drug (NSAID) was used in all of these groups unless there was a contraindication. Postoperative complications were defined as inadequate analgesia, sedation, unplanned mechanical ventilation requirement, nausea-vomiting. Length of stay for each patient was also recorded. Results: Between January-December 2007 there were 233 patients undergoing thoracotomy. Although efficient analgesia was obtained in most of patients (205; 88 %); most common complication was inadequate analgesia which was seen in 28 subjects. Significantly less patients in TEA group complained of pain and required rescue analgesic. Correlation between inadequate, pain control and longer length of stay was observed in patients with lobectomy (p<0.001). Type of incision did not affect the need for rescue analgesic. Conclusion: In our retrospective study, TEA seemed as the best alternative for analgesia after thoracotomy. With, a standadized surgical procedure inadequate analgesia affected length of stay; this was a remarkable result of this retrospective study. Pain control after thoracotomy is feasible with an agressive multimodal analgesia protocol. Adequate analgesia may ameliorate recovery and so affect patients morbidity in this population.