Ipsilateral shoulder pain after thoracotomy with epidural analgesia: the influence of phrenic nerve infiltration with lidocaine.

Abstract:

UNLABELLED:Patients receiving effective thoracic epidural analgesia for postthoracotomy pain may still complain of severe ipsilateral shoulder pain. The etiology of this pain is unclear. In this randomized, double-blinded, placebo-controlled study, we investigated the effect of phrenic nerve infiltration with lidocaine or saline on postoperative shoulder pain in 48 patients. After completion of a lung resection, patients received either 10 mL of 1% lidocaine or 10 mL of 0.9% saline infiltrated into the periphrenic fat pad at the level of the diaphragm. Shoulder pain was experienced by 33% of patients receiving lidocaine, compared with 85% of patients receiving saline (P < 0.008). Overall pain scores were lower with lidocaine (P < 0.05). PaCO(2) values were not significantly higher with lidocaine in the first 2 h. We conclude that pain transmitted via the phrenic nerve and referred to the shoulder is the most likely explanation for the ipsilateral shoulder pain experienced by patients receiving epidural analgesia for postthoracotomy pain. IMPLICATIONS:Ipsilateral shoulder pain after thoracotomy is common and may be severe, even in the presence of a functioning thoracic epidural. We have shown that infiltration of the phrenic nerve with local anesthetic significantly and safely reduces this shoulder pain, potentially allowing the ideal goal of a pain-free thoracotomy.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Scawn ND,Pennefather SH,Soorae A,Wang JY,Russell GN

doi

10.1097/00000539-200108000-00004

subject

Has Abstract

pub_date

2001-08-01 00:00:00

pages

260-4, 1st contents page

issue

2

eissn

0003-2999

issn

1526-7598

journal_volume

93

pub_type

临床试验,杂志文章,随机对照试验
  • Comparison of desflurane with propofol in outpatients undergoing peripheral orthopedic surgery.

    abstract::This study was undertaken to compare desflurane with propofol anesthesia in outpatients undergoing peripheral orthopedic surgery. Data were combined from two institutions participating in a multicenter study. Ninety-one patients, ASA physical status I or II, were each randomly assigned to one of four groups. After adm...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199210000-00019

    authors: Rapp SE,Conahan TJ,Pavlin DJ,Levy WJ,Hautman B,Lecky J,Luke J,Nessly ML

    更新日期:1992-10-01 00:00:00

  • Plasma potentiates the priming effects of endotoxin on platelet activating factor-induced pulmonary hypertension in the rabbit lung.

    abstract::During Gram-negative sepsis, endotoxin lipopolysaccharide (LPS) may activate host inflammatory responses, resulting in the systemic inflammatory response syndrome and the adult respiratory distress syndrome. In cell culture systems, LPS activation of cellular responses may be potentiated by plasma proteins. In the iso...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199608000-00008

    authors: Goldsmith JA,Kavanagh BP,Pearl RG

    更新日期:1996-08-01 00:00:00

  • Severity of baseline pain and degree of analgesia in the third molar post-extraction dental pain model.

    abstract:UNLABELLED:The purpose of this study was to determine whether different levels of pain would respond similarly to analgesia. We compared the analgesic response to ibuprofen in subjects with moderate versus severe baseline pain in clinical trials using the third molar post-extraction dental pain model. We performed a po...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ane.0000063827.97392.5e

    authors: Averbuch M,Katzper M

    更新日期:2003-07-01 00:00:00

  • Adding clonidine to the induction bolus and postoperative infusion during continuous femoral nerve block delays recovery of motor function after total knee arthroplasty.

    abstract::We evaluated the effects of adding clonidine for continuous peripheral nerve infusions. Sixty patients undergoing total knee arthroplasty under combined single-injection sciatic block and continuous femoral infusion were randomly allocated to three groups: block induction with 0.75% ropivacaine followed by 0.2% ropiva...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000143952.75985.8F

    authors: Casati A,Vinciguerra F,Cappelleri G,Aldegheri G,Fanelli G,Putzu M,Chelly JE

    更新日期:2005-03-01 00:00:00

  • Decrease in vascular resistance in the isolated canine hindlimb after graded doses of alfentanil, fentanyl, and sufentanil.

    abstract::Under halothane anesthesia five dogs were prepared with both hindlimbs isolated from the systemic circulation to allow intermittent placement on extracorporeal perfusion at constant flow. One limb of each dog was surgically denervated. In this relatively anesthetic-free preparation, graded equivalent doses of alfentan...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199007000-00005

    authors: White DA,Reitan JA,Kien ND,Thorup SJ

    更新日期:1990-07-01 00:00:00

  • Systemic physostigmine shows antiallodynic effects in neuropathic rats.

    abstract:UNLABELLED:The aim of this study was to examine the antiallodynic and antinociceptive effects of subcutaneously administered physostigmine (50, 100, 200 micrograms/kg), compared with morphine (2.5, 5, 10 mg/kg) and NaCl after spinal nerve ligation in rats. The following stimuli were used: acetone (cold allodynia), von ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199908000-00033

    authors: Pöyhiä R,Xu M,Kontinen VK,Paananen S,Kalso E

    更新日期:1999-08-01 00:00:00

  • Multimodal antiemetic management prevents early postoperative vomiting after outpatient laparoscopy.

    abstract::Because no completely effective antiemetic exists for the prevention of postoperative nausea and vomiting (PONV), we hypothesize that a multimodal approach to management of PONV may reduce both vomiting and the need for rescue antiemetics in high-risk patients. After IRB approval, women undergoing outpatient laparosco...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200012000-00020

    authors: Scuderi PE,James RL,Harris L,Mims GR 3rd

    更新日期:2000-12-01 00:00:00

  • The effect of short-term epidural local anesthetic blockade on urinary levels of substance P in interstitial cystitis.

    abstract:UNLABELLED:We investigated the effect of epidural local anesthetic blockade on urinary substance P levels in five patients suffering from painful flare-ups of interstitial cystitis. Urine was collected in 24-h intervals commencing at the onset of an epidural bolus of 0.25% bupivacaine followed by maintenance epidural i...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ane.0000099362.01312.3a

    authors: Sukiennik A,Carr DB,Bonney I,Marchand JE,Wurm H,Sant GR

    更新日期:2004-03-01 00:00:00

  • Cerebellar hemorrhage caused by cerebrospinal fluid leak after spine surgery.

    abstract::Spine surgery is associated with a wide range of surgical and anesthetic complications. Excessive cerebrospinal fluid leak can be a cause of cerebellar hemorrhage postoperatively. We report a 43-yr-old patient who had lumbar spine reexploration surgery complicated by a cerebrospinal fluid leak which led to cerebellar ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000143340.51813.6A

    authors: Farag E,Abdou A,Riad I,Borsellino SR,Schubert A

    更新日期:2005-02-01 00:00:00

  • Effects of Electrical Transcutaneous Vagus Nerve Stimulation on the Perceived Intensity of Repetitive Painful Heat Stimuli: A Blinded Placebo- and Sham-Controlled Randomized Crossover Investigation.

    abstract:BACKGROUND:Transcutaneous vagus nerve stimulation (TVNS) is a promising treatment for acute and chronic pain. However, experimental studies yielded controversial results. We examined if TVNS reduces the perceived intensity of repetitive painful heat stimulation and temporal summation of pain (TSP) in healthy volunteers...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000002820

    authors: Janner H,Klausenitz C,Gürtler N,Hahnenkamp K,Usichenko TI

    更新日期:2018-06-01 00:00:00

  • The additive pulmonary vasodilatory effects of inhaled prostacyclin and inhaled milrinone in postcardiac surgical patients with pulmonary hypertension.

    abstract:UNLABELLED:Selective pulmonary vasodilation is an advantageous therapeutic strategy for cardiac surgical patients with increased pulmonary vascular resistance (PVR) and right ventricular failure. We hypothesized that milrinone, an adenosine-3',5'-cyclic monophosphate (cAMP)-selective phosphodiesterase enzyme (PDE) inhi...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-200112000-00018

    authors: Haraldsson s A,Kieler-Jensen N,Ricksten SE

    更新日期:2001-12-01 00:00:00

  • Plasma level of N terminal pro-brain natriuretic peptide as a prognostic marker in critically ill patients.

    abstract::We studied whether N-terminal pro brain natriuretic peptide (NT-pro BNP) measured at intensive care unit admission is an independent predictor of mortality in critically ill patients. We conducted a prospective observational cohort study enrolling 78 patients with APACHE II scores more than 12. Serum NT-pro BNP and ca...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000217202.55909.5d

    authors: Almog Y,Novack V,Megralishvili R,Kobal S,Barski L,King D,Zahger D

    更新日期:2006-06-01 00:00:00

  • The Kepler intubation system.

    abstract::Our goal in this study was to develop a robotic intubation system and to conduct a feasibility pilot study on the use of a robotic intubation system for endotracheal intubations. The Kepler Intubation System was developed, consisting of a remote control center (joystick and intubation cockpit) linked to a standard vid...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182410cbf

    authors: Hemmerling TM,Wehbe M,Zaouter C,Taddei R,Morse J

    更新日期:2012-03-01 00:00:00

  • The care of patients with phantom limb pain in a pain clinic.

    abstract::Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical e...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197711000-00019

    authors: Blankenbaker WL

    更新日期:1977-11-01 00:00:00

  • Morphine kinetics and kidney transplantation: morphine removal is influenced by renal ischemia.

    abstract::Morphine plasma concentrations were determined in six patients receiving kidney transplants from living-related donors, and nine patients receiving kidney transplants from cadavers. The total cold ischemic time was about 2 hr for kidneys from living-related donors and 14 hr for those from cadavers. After an intravenou...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Sear J,Moore A,Hunniset A,Baldwin D,Allen M,Hand C,McQuay H,Morris P

    更新日期:1985-11-01 00:00:00

  • Use of alfentanil and propofol for outpatient monitored anesthesia care: determining the optimal dosing regimen.

    abstract:UNLABELLED:Propofol and alfentanil are both rapid and short-acting drugs that can be used for sedation and analgesia during monitored anesthesia care (MAC). This study was designed to determine the optimal infusion rates of propofol and alfentanil when administered during local anesthesia. In this randomized, double-bl...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199709000-00015

    authors: Avramov MN,White PF

    更新日期:1997-09-01 00:00:00

  • Transcutaneous regional venous oximetry: a feasibility study.

    abstract:BACKGROUND:The arterial pulse oximeter, which was introduced clinically in the 1970s, is a convenient, useful, and now ubiquitous anesthesia monitor. Unfortunately, although percent saturation of arterial hemoglobin is, along with cardiac output and concentration of hemoglobin, one of 3 components of oxygen delivery, i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182166a26

    authors: Thiele RH,Tucker-Schwartz JM,Lu Y,Gillies GT,Durieux ME

    更新日期:2011-06-01 00:00:00

  • Right Ventricular Longitudinal Strain Is Depressed in a Bovine Model of Pulmonary Hypertension.

    abstract:BACKGROUND:Pulmonary hypertension and resulting right ventricular (RV) dysfunction are associated with significant perioperative morbidity and mortality. Although echocardiography permits real-time, noninvasive assessment of RV function, objective and comparative measures are underdeveloped, and appropriate animal mode...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001215

    authors: Bartels K,Brown RD,Fox DL,Bull TM,Neary JM,Dorosz JL,Fonseca BM,Stenmark KR

    更新日期:2016-05-01 00:00:00

  • Transdermal nicotine for analgesia after radical retropubic prostatectomy.

    abstract:BACKGROUND:Previous animal and human studies suggested that nicotine might have an antinociceptive effect. We hypothesized that the preoperative application of a 7 mg nicotine patch would result in reduced postoperative analgesic requirements in patients undergoing radical retropubic prostatectomy (RRP) under general a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ane.0b013e31816f2616

    authors: Habib AS,White WD,El Gasim MA,Saleh G,Polascik TJ,Moul JW,Gan TJ

    更新日期:2008-09-01 00:00:00

  • Effect of Sevoflurane Versus Isoflurane on Emergence Time and Postanesthesia Care Unit Length of Stay: An Alternating Intervention Trial.

    abstract:BACKGROUND:We previously reported that the duration of hospitalization was not different between isoflurane and sevoflurane. But more plausible consequences of using soluble volatile anesthetics are delayed emergence from anesthesia and prolonged stays in the postanesthesia care unit (PACU). We therefore compared isofl...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/ANE.0000000000004093

    authors: Maheshwari K,Ahuja S,Mascha EJ,Cummings KC 3rd,Chahar P,Elsharkawy H,Kurz A,Turan A,Sessler DI

    更新日期:2020-02-01 00:00:00

  • The effect of single-injection femoral nerve block versus continuous femoral nerve block after total knee arthroplasty on hospital length of stay and long-term functional recovery within an established clinical pathway.

    abstract::Total knee arthroplasty (TKA) may result in severe pain, and single-injection femoral nerve blocks (SFNB) have been demonstrated to have a limited duration of analgesia. Continuous femoral nerve blocks (CFNB) can prolong the analgesic duration of SFNB. We prospectively randomized 36 patients undergoing TKA to CFNB ver...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000198675.20279.81

    authors: Salinas FV,Liu SS,Mulroy MF

    更新日期:2006-04-01 00:00:00

  • Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety.

    abstract:BACKGROUND:Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reduci...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析

    doi:10.1213/ANE.0000000000004165

    authors: Eijlers R,Utens EMWJ,Staals LM,de Nijs PFA,Berghmans JM,Wijnen RMH,Hillegers MHJ,Dierckx B,Legerstee JS

    更新日期:2019-11-01 00:00:00

  • Spinal anesthesia with hyperbaric levobupivacaine and ropivacaine for outpatient knee arthroscopy: a prospective, randomized, double-blind study.

    abstract::To compare unilateral spinal block produced with small doses of hyperbaric ropivacaine with that produced by 2 doses of hyperbaric levobupivacaine, we randomly allocated 91 ASA physical status I-II outpatients undergoing knee arthroscopy to receive unilateral spinal anesthesia with 7.5 mg of hyperbaric ropivacaine 0.5...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000155265.79673.56

    authors: Cappelleri G,Aldegheri G,Danelli G,Marchetti C,Nuzzi M,Iannandrea G,Casati A

    更新日期:2005-07-01 00:00:00

  • Differential changes of alveolar gas concentrations during anesthetic induction of a patient with an absent right pulmonary artery.

    abstract::A 38-yr-old man with congenital right pulmonary artery agenesis, whose right lung was perfused with collateral systemic arterial blood, presented for right pneumonectomy. Because of a likely difference in gas exchange between the two lungs, we sampled end-tidal gases from each lung individually, as well as from the co...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000226089.53300.7a

    authors: Jiang Y,Wain JC,Chang AW,Zapol WM,Xie Z

    更新日期:2006-08-01 00:00:00

  • Glymphatic System Function in Relation to Anesthesia and Sleep States.

    abstract::The brain is one of the most metabolically active organs in the body. The brain's high energy demand associated with wakefulness persists during rapid eye movement sleep, and even during non-rapid eye movement sleep, cerebral oxygen consumption is only reduced by 20%. The active bioenergetic state parallels metabolic ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000004069

    authors: Benveniste H,Heerdt PM,Fontes M,Rothman DL,Volkow ND

    更新日期:2019-04-01 00:00:00

  • The effects of intravenous lidocaine administration on the minimum alveolar concentration of isoflurane in cats.

    abstract::Lidocaine decreases the minimum alveolar concentration (MAC) of inhaled anesthetics and has been used clinically to reduce the requirements for other anesthetic drugs. In this study we examined the effects of lidocaine on isoflurane MAC in cats. Six cats were studied. In Experiment 1, the MAC of isoflurane was determi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000139350.88158.38

    authors: Pypendop BH,Ilkiw JE

    更新日期:2005-01-01 00:00:00

  • Designing meaningful industry metrics for clinical productivity for anesthesiology departments.

    abstract:IMPLICATIONS:Clinical productivity measurements that account for differences in clinical settings and concurrencies provided more precise comparisons between two anesthesiology groups. The data show that different concurrencies confound the current industry standard, "per full-time equivalent" measurements, whereas "pe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200108000-00014

    authors: Abouleish AE,Prough DS,Zornow MH,Lockhart A,Abate JJ,Hughes J

    更新日期:2001-08-01 00:00:00

  • Bronchial mucus transport velocity in paralyzed anesthetized patients: a comparison of the laryngeal mask airway and cuffed tracheal tube.

    abstract:UNLABELLED:We compared bronchial mucus transport velocity (BTV), an index of mucociliary clearance, between the laryngeal mask airway (LMA) and the tracheal tube (TT). Forty patients were studied during propofol anesthesia and muscle relaxation with rocuronium. BTV was measured 10 and 60 min after insertion of the airw...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199806000-00028

    authors: Keller C,Brimacombe J

    更新日期:1998-06-01 00:00:00

  • Percutaneous tracheostomy with single dilatation technique: a prospective, randomized comparison of Ciaglia blue rhino versus Griggs' guidewire dilating forceps.

    abstract:UNLABELLED:Percutaneous tracheostomy with single-step dilation technique using Griggs' guidewire dilating forceps (GWDF) is a well-recognized procedure. Recently, Ciaglia has introduced a one-step dilation technique using a curved, gradually tapered dilator, the Ciaglia Blue Rhino (CBR). In a prospective, randomized st...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200212000-00050

    authors: Ambesh SP,Pandey CK,Srivastava S,Agarwal A,Singh DK

    更新日期:2002-12-01 00:00:00

  • Levobupivacaine-sufentanil with or without epinephrine during epidural labor analgesia.

    abstract::In a prospective, randomized, double-blind study, we investigated whether epinephrine increased the efficacy of levobupivacaine and sufentanil during epidural labor analgesia. Seventy term parturients received an epidural injection of levobupivacaine 0.125% and sufentanil 0.75 microg/mL with or without 1:800,000 epine...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1213/01.ane.0000221038.46094.c0

    authors: Soetens FM,Soetens MA,Vercauteren MP

    更新日期:2006-07-01 00:00:00