Long-term pain and activity during recovery from major thoracotomy using thoracic epidural analgesia.

Abstract:

BACKGROUND:Pain following thoracotomy can persist for years with an undetermined impact on quality of life. Factors hypothesized to modulate this painful experience include analgesic regimen, gender, and type of incision. METHODS:A total of 157 generally healthy patients of both genders scheduled for segmentectomy, lobectomy, or bilobectomy through a posterolateral or muscle-sparing incision were randomly assigned to receive thoracic epidural analgesia initiated prior to incision or at the time of rib approximation. Pain and activity scores were obtained 4, 8, 12, 24, 36, and 48 weeks after surgery. RESULTS:Overall, there were no differences in pain scores between the control and intervention groups during hospitalization (P >or= 0.165) or after discharge (P>or= 0.098). The number of patients reporting pain 1 yr following surgery (18 of 85; 21.2%) was not significantly different (P = 0.122) from the number reporting preoperative pain (15 of 120; 12.5%). During hospitalization, women reported greater pain than men (worst pain, P= 0.007; average pain, P= 0.016). Women experienced fewer supraventricular tachydysrhythmias (P = 0.013) and were thus discharged earlier (P = 0.002). After discharge women continued to report greater discomfort than men (P

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Ochroch EA,Gottschalk A,Augostides J,Carson KA,Kent L,Malayaman N,Kaiser LR,Aukburg SJ

doi

10.1097/00000542-200211000-00029

subject

Has Abstract

pub_date

2002-11-01 00:00:00

pages

1234-44

issue

5

eissn

0003-3022

issn

1528-1175

pii

00000542-200211000-00029

journal_volume

97

pub_type

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