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British Journal of Anaesthesia 2007 98(2):159-162; doi:10.1093/bja/ael360
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Pain relief after thoracotomy: is epidural analgesia the optimal technique?

The first 150 words of the full text of this article appear below.

Thoracotomy is often performed in patients with pre-existing lung disease such as lung cancer and chronic obstructive pulmonary disease. It is associated with the potential for severe pain, further impairment of lung function, delayed recovery and the occurrence of chronic pain.1–3 The provision of pain relief is a major consideration and thoracic epidural analgesia is often regarded to be the gold standard. However, epidural analgesia is not always ideal and other useful regional methods of analgesia after thoracotomy have been proposed. This editorial illustrates some of the reasons for severe pain after thoracotomy and shows that there are alternatives to epidural analgesia.

To understand why thoracotomy is associated with much pain and thus the necessity for high-quality analgesia, it is important to understand the pathophysiology of tissue damage.

  • Rib retraction and intercostal nerve damage. During thoracotomy, the lateral chest wall is incised, tissue dissected, and a retractor placed in an . . . [Full Text of this Article]

A. Ng*

Department of Anaesthesia, Critical Care and Pain Management
The Heart and Lung Centre
New Cross Hospital
Wolverhampton WV10 0QP
UK

J. Swanevelder

Department of Anaesthesia, Critical Care and Pain Management
University Hospitals of Leicester NHS Trust
Glenfield Hospital
Leicester LE3 9QP
UK

* E-mail: Alexander.Ng@rwh-tr.nhs.uk


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This article has been cited by other articles:


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I. McGovern, C. Walker, F. Cox, A. Ng, and J. Swanevelder
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Br. J. Anaesth., June 1, 2007; 98(6): 844 - 845.
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E-letters:

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Pain relief after thoracotomy
Ian McGovern, et al.
British Journal of Anaesthesia, 16 Feb 2007 [Full text]
Pain relief after thoracotomy
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British Journal of Anaesthesia, 13 Mar 2007 [Full text]
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British Journal of Anaesthesia, 10 Jun 2007 [Full text]
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