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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 ne...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Pneumologia e Tisiologia
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083640/ https://www.ncbi.nlm.nih.gov/pubmed/24831401 http://dx.doi.org/10.1590/S1806-37132014000200010 |
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author | Marchetti-Filho, Marco Aurélio Leão, Luiz Eduardo Villaça Costa-Junior, Altair da Silva |
author_facet | Marchetti-Filho, Marco Aurélio Leão, Luiz Eduardo Villaça Costa-Junior, Altair da Silva |
author_sort | Marchetti-Filho, Marco Aurélio |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-4083640 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-40836402014-07-16 The role of intercostal nerve preservation in acute pain control after thoracotomy Marchetti-Filho, Marco Aurélio Leão, Luiz Eduardo Villaça Costa-Junior, Altair da Silva J Bras Pneumol Original Articles 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. Sociedade Brasileira de Pneumologia e Tisiologia 2014 /pmc/articles/PMC4083640/ /pubmed/24831401 http://dx.doi.org/10.1590/S1806-37132014000200010 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Marchetti-Filho, Marco Aurélio Leão, Luiz Eduardo Villaça Costa-Junior, Altair da Silva The role of intercostal nerve preservation in acute pain control after thoracotomy |
title | 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_short | 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 |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083640/ https://www.ncbi.nlm.nih.gov/pubmed/24831401 http://dx.doi.org/10.1590/S1806-37132014000200010 |
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