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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pain is one of the most important considerations in the care of thoracic surgical patients. Failure in pain management is associated with increased mortality and morbidity. Acute pain management aspires to stop the painful stimuli before it is transferred to the CNS. The authors recommend (1) a thorough explanation of the operation and the expected outcome to the patient, (2) preoperative pulmonary rehabilitation for those with marginal lung function, (3) choosing the least painful surgical approach with acceptable exposure, (4) minimizing tissue trauma during surgery, (5) preemptive analgesia, and (6) early ambulation as prophylactic measures that should be employed during hospitalization. Good acute pain control should reduce the incidence of chronic pain. Mediansternotomy and VATS seem to be less acutely painful approaches than thoracotomy for most thoracic surgery. One should rule out recurrent malignancy as the etiology for chronic or recurrent pain. Opioids and NSAIDs are sufficient to produce optimal pain control in patients who undergo VATS and sternotomv. TEA is typically reserved for patients who have a thoracotomy. Opioid PCA can be used instead of-or after the discontinuation of-the epidural catheter. Chronic pain can be treated in many ways, and input from a pain clinic might be beneficial. The single best approach to chronic pain is to prevent it. This can be achieved by selecting the right incisional approach, instituting early physical therapy, and achieving optimal postoperative pain control.
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PMID:Acute and chronic pain syndromes after thoracic surgery. 1247 33

Pain is a significant consequence of cardiac surgery and newer techniques in cardiac anesthesia have provided an impetus for the development of multimodal techniques to manage acute pain in this setting. In this regard, regional anesthesia techniques have been increasingly used in many cardiac surgical procedures, for the purposes of reducing perioperative consumption of opioid agents and enhanced recovery after surgery. The present investigation focuses on most currently used regional techniques in cardiac surgical procedures. These regional techniques include chest wall blocks (e.g., PECS I and II, SAP, ESB, PVB), sternal blocks (e.g., TTMPB, PSINB), and neuraxial blocks (e.g., TEA, high spinal anesthesia). The present investigation also summarizes indications, technique, complications, and potential clinical benefits of these evolving regional techniques. Cardiac surgery patients may benefit from application of these regional techniques with well controlled indications and careful patient selections.
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PMID:Regional anesthesia considerations for cardiac surgery. 3179 58