REVIEW   Free access

Minerva Anestesiologica 2023 November;89(11):1022-33

DOI: 10.23736/S0375-9393.23.17291-9

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Pain management after thoracic surgery or chest trauma

Sarah FERAY ¹ ✉, Adrien LEMOINE ¹, Christophe AVELINE ², Christophe QUESNEL ¹

¹ Department of Anesthesia and Surgical Intensive Care, Hôpital Tenon, APHP, Paris, France; ² Department of Anesthesia and Surgical Intensive Care, Sévigné Hospital, Cesson Sévigné, France

Accidental or surgically induced thoracic trauma is responsible for significant pain that can impact patient outcomes. One of the main objectives of its pain management is to promote effective coughing and early mobilization to reduce atelectasis and ventilation disorders induced by pulmonary contusion. The incidence of chronic pain can affect more than 35% of patients after both thoracotomy and thoracoscopy as well as after chest trauma. As the severity of acute pain is associated with the incidence of chronic pain, early and effective pain management is very important. In this narrative review, we propose to detail systemic and regional analgesia techniques to minimize postoperative pain, while reducing transitional pain, surgical stress response and opioid side effects. We provide the reader with practical recommendations based on both literature and clinical practice experience in a referral level III thoracic trauma center.

KEY WORDS: Thoracic injuries; Thoracic surgery; Pain management; Conduction anesthesia