الفهرس Only 14 pages are availabe for public view
 |  | from | 136 |  |  |
| | | from | 136 | | |
Abstract
الملخص There are many operations performed through thoracotomy such as operations of the heart, the pericardium, the lungs, the pleura, the great vessels, and the esophagus.Pain treatment after thoracic operations is particularly important because the postoperative recovery of such patients is dependant on the maintenance of respiratory function.. Postthoracotomy pain is actually more severe than other types of postoperative pain leading to Pulmonary dysfunction.
The sources of pain are multiple, i.e. the site of the surgical incision, damage to ribs and intercostal nerves, inflammation of chest wall structures, incision or crushing of pulmonary pleura and the placement of thoracotomy drainage tubes.
Systemic opioids have been traditionally used for the treatment of postthoracotomy pain. They are still the drugs of choice in treating postthoractomy pain specially by intravenous route as such pain is very severe which makes simple analgesics ineffective. The main disadvantage of opioids is respiratory depression.
In recent years, new methods and techniques have been used to control the pain after thoracotomy.Such techniques may be systemic such as non steroidal anti inflammatory drugs and ketamine or regional such as paravertebral block, epidural block, intercostal block, interpleural analgesia, and intrathecal analgesia. Other methods can be used like cryoanalgesia and transcutaneous electrical nerve stimulation.
In fact, it’s really difficult to detect the best method to manage the post thoracotomy pain but combing the systemic techniques with regional techniques usually give good results with less incidence of adverse effects.