Has analgesia changed for lung resection surgery?

Has analgesia changed for lung resection surgery? Analgesia is paramount following lung resection surgery as it enables maximal effort for optimal ventilatory function. Although opioids are useful analgesics, there is an advantage to using multi‐modal analgesic techniques in order to limit opioid side‐effects, particularly respiratory depression and sedation. Regional analgesia is a key component of this multi‐modal analgesic regime. This editorial will discuss recent changes in analgesia for lung resection surgery and the authors’ experience in analgesia for lung resection.Gold‐standard regional techniquesThoracic epidural analgesia (henceforth referred to as epidural) has historically been the gold‐standard regional technique for thoracic surgery. Over the last 10 years, epidural use has reduced as paravertebral blocks have become increasingly popular in many centres in the UK. In 2010, anaesthetists working in thoracic surgery centres in the UK were surveyed to see what analgesic technique was their first choice for various types of thoracic surgery. Half of the anaesthetists preferred paravertebral blocks with patient‐controlled analgesia for video‐assisted thoracoscopic lobectomy, whereas one‐third preferred patient‐controlled analgesia alone and only one‐tenth preferred epidurals . Patients undergoing open lung resection were grouped with patients having pleural decortication, making it difficult to determine preferred practice for open lung resection alone. Half of anaesthetists preferred epidurals for open procedures, whereas http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anaesthesia Wiley

Has analgesia changed for lung resection surgery?

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Publisher
Wiley
Copyright
Copyright © 2018 The Association of Anaesthetists of Great Britain and Ireland
ISSN
0003-2409
eISSN
1365-2044
D.O.I.
10.1111/anae.14188
Publisher site
See Article on Publisher Site

Abstract

Analgesia is paramount following lung resection surgery as it enables maximal effort for optimal ventilatory function. Although opioids are useful analgesics, there is an advantage to using multi‐modal analgesic techniques in order to limit opioid side‐effects, particularly respiratory depression and sedation. Regional analgesia is a key component of this multi‐modal analgesic regime. This editorial will discuss recent changes in analgesia for lung resection surgery and the authors’ experience in analgesia for lung resection.Gold‐standard regional techniquesThoracic epidural analgesia (henceforth referred to as epidural) has historically been the gold‐standard regional technique for thoracic surgery. Over the last 10 years, epidural use has reduced as paravertebral blocks have become increasingly popular in many centres in the UK. In 2010, anaesthetists working in thoracic surgery centres in the UK were surveyed to see what analgesic technique was their first choice for various types of thoracic surgery. Half of the anaesthetists preferred paravertebral blocks with patient‐controlled analgesia for video‐assisted thoracoscopic lobectomy, whereas one‐third preferred patient‐controlled analgesia alone and only one‐tenth preferred epidurals . Patients undergoing open lung resection were grouped with patients having pleural decortication, making it difficult to determine preferred practice for open lung resection alone. Half of anaesthetists preferred epidurals for open procedures, whereas

Journal

AnaesthesiaWiley

Published: Jan 1, 2018

Keywords: ; ; ;

References

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