Regional Anaesthesia for Thoracic Surgery

  • J. B. Brodsky


Thoracic operations include a wide variety of different operative approaches. Most procedures are performed under general anaesthesia since controlled one-lung ventilation (OLV) is usually required. Analgesia strategies involving regional anaesthetic techniques are usually instituted prior to or during surgery in anticipation of postoperative pain. Different incisions are associated with varying degrees of postoperative pain. In general, the lateral thoracotomy incision is considered the most painful, median sternotomy less so, and video-assisted thoracoscopic surgery (VATS) the least painful. In addition to the skin incision, disruption of intercostal nerves, inflammation of the chest wall, diaphragm and pleura, and the number and sites of chest drainage tubes all influence pain. Patients also experience pain at non-incisional sites, particularly ipsilateral shoulder pain, which often follows thoracotomy and VATS procedures.


Epidural Analgesia Transcutaneous Electric Nerve Stimulation Intercostal Nerve Brachial Plexus Block Chest Drainage Tube 
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Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • J. B. Brodsky
    • 1
  1. 1.Department of AnesthesiaStanford University School of MedicineStanfordUSA

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