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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postoperative pain management is essential and must be approached as an integral part of the perioperative care. It should be systematic and based on sound physiologic and pharmacologic principles. The intra-operative management of pain is crucial, as there is perhaps an important role for preemptive analgesia. Because of its unique nature, pain is difficult to assess, but for good results adequate and repeated assessment are vital. The literature also points to the detrimental effects of inadequate pain control. There are a variety of methods available for pain management. In choosing a method, various factors need to be considered including physician skill, knowledge of analgesics and routes of administration, patient-related and clinical circumstances, the availability of an environment supportive of effective pain management, and the knowledge and skill of staff to assess and monitor patients. These need to be considered along with the risks and benefits and cost-benefit of the various drugs and techniques. The cornerstone of therapy is opioids, which can be administered by a variety of routes. The use of TEA with opioids and local anesthetics is highly beneficial, especially in high-risk patients. The aim should be to provide all patients a balanced analgesic regimen based on the identification of multiple mechanisms involved in postoperative pain.
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PMID:Postoperative pain management. 940 91

This case report describes an anesthetic management of a patient who received successful concomitant coronary artery bypass grafting without cardiopulmonary bypass and left lower lobectomy. A 66-year-old man presented for left lower lobectomy. His medical history included angina pectoris under control with isosorbide and nifedipine. Preoperative coronary angiography revealed multiple stenosis [100% at right coronary artery (# 2), 99% at left anterodescending artery (# 7) and 90% at left circumflex artery (# 11)]. Concomitant coronary artery bypass grafting without cardiopulmonary bypass and left lower lobectomy were scheduled. Anesthesia was maintained with combined total intravenous anesthesia (propofol and fentanyl) and continuous thoracic epidural anesthesia. Postoperative pain was well controlled with continuous epidural analgesia (TEA) and patient control analgesia (PCA). There were no signs of postoperative respiratory complications and myocardial ischemia. Combined total intravenous and continuous thoracic epidural anesthesia has multiple benefits for concomitant coronary artery bypass grafting without cardiopulmonary bypass and left lower lobectomy.
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PMID:[Anesthetic management of concomitant coronary artery bypass grafting without cardiopulmonary bypass and left lower lobectomy]. 1107 68