Postthoracotomy Ipsilateral Shoulder Pain: A Literature Review on Characteristics and Treatment.

Abstract:

:Context. Postthoracotomy Ipsilateral Shoulder Pain (IPS) is a common and sometimes intractable pain syndrome. IPS is different from chest wall pain in type, origin, and treatments. Various treatments are suggested or applied for it but none of them is regarded as popular accepted effective one. Objectives. To review data and collect all present experiences about postthoracotomy IPS and its management and suggest future research directions. Methods. Search in PubMed database and additional search for specific topics and review them to retrieve relevant articles as data source in a narrative review article. Results. Even in the presence of effective epidural analgesia, ISP is a common cause of severe postthoracotomy pain. The phrenic nerve has an important role in the physiopathology of postthoracotomy ISP. Different treatments have been applied or suggested. Controlling the afferent nociceptive signals conveyed by the phrenic nerve at various levels-from peripheral branches on the diaphragm to its entrance in the cervical spine-could be of therapeutic value. Despite potential concerns about safety, intrapleural or phrenic nerve blocks are tolerated well, at least in a selected group of patient. Conclusion. Further researches could be directed on selective sensory block and motor function preservation of the phrenic nerve. However, the safety and efficacy of temporary loss of phrenic nerve function and intrapleural local anesthetics should be assessed.

journal_name

Pain Res Manag

authors

Yousefshahi F,Predescu O,Colizza M,Asenjo JF

doi

10.1155/2016/3652726

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

3652726

eissn

1203-6765

issn

1918-1523

journal_volume

2016

pub_type

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