Post- Thoracotomy Pulmonary Mechanics

ABSTRACTIntroduction : The post-thoracotomy patient will typically experience sever post-operative pain unless aggressive pain management techniques are employed. Patients and method : This work is a blindly randomized prospective study of sixty adult patients studied in Zagazig University Hospital Department of Cardiothoracic Surgery from December 2003 to December 2005. To evaluate the relative efficacy of the extra-pleural catheter infusion technique of local anesthetic as compared to the epidural catheter infusion technique and to parenteral analgesia on pain outcome and postoperative pulmonary mechanics. Results : Extra-pleural analgesia is a safe method for postoperative pain control after elective lung operation and for decreasing of postoperative respiratory complications. Extra-pleural analgesia is alternative to thoracic epidural analgesia. Also, extra-pleural analgesia is superior to traditional therapy for pain control after thoracotomy with conventional analgesia [systemic opioids (IM/IV)/patient controlled analgesia or IV-PCA]. Conclusion : There are a variety of methods available for post-thoracotomy pain management. Extra-pleural analgesia with local anesthetic have been found useful in reducing systemic opioids needed, and thus, reducing the systemic side effects of opioids, and had a better restoration of postoperative pulmonary function.