Titre
Thoracotomy and thoracoscopy: postoperative pulmonary function, pain and chest wall complaints
Type
article
Institution
Externe
Périodique
Auteur(s)
Furrer, M.
Auteure/Auteur
Rechsteiner, R.
Auteure/Auteur
Eigenmann, V.
Auteure/Auteur
Signer, C.
Auteure/Auteur
Althaus, U.
Auteure/Auteur
Ris, H. B.
Auteure/Auteur
Liens vers les personnes
ISSN
1010-7940
Statut éditorial
Publié
Date de publication
1997-07
Volume
12
Numéro
1
Première page
82
Dernière page/numéro d’article
7
Notes
Comparative Study
Journal Article --- Old url value: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9262085 --- Old month value: Jul
Journal Article --- Old url value: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9262085 --- Old month value: Jul
Résumé
OBJECTIVE: Two different surgical accesses combined with standard pain management procedures are compared regarding early and intermediate pulmonary function and pain relief. METHODS: In a prospective study, 15 consecutive patients undergoing video-thoracoscopy for pulmonary wedge resection (group 1) were matched to 15 patients undergoing standard postero-lateral thoracotomy for lobectomy (group 2) according to age, gender and preoperative pulmonary function. Postoperative pain control consisted of patient controlled analgesia in group 1 and epidural analgesia in group 2. Pain intensity was scored from 0-4. The predicted postoperative pulmonary function (FVC and FEV 1) after lobectomies was calculated from the preoperative value according to the extent of resection. A clinical measurement was obtained after a mean follow-up time of 4.2 months. RESULTS: The ratios of postoperative measured to predicted values of FVC and FEV1 for group 1 compared with group 2 were 0.64 +/- 0.15 and 0.65 +/- 0.14 compared with 0.60 +/- 0.19 and 0.59 +/- 0.13, resp. (both n.s.) at the first day postoperative; 0.92 +/- 0.18 and 0.95 /- 0.17 compared with 0.76 +/- 0.20 (P < 0.05) and 0.83 +/- 0.23 (n.s.), resp. at hospital discharge; 0.98 +/- 0.10 and 0.94 +/- 0.14 compared with 1.01 +/- 0.17 (n.s.) and 1.10 +/- 0.17 (P < 0.05), resp. at follow-up. Pain intensity score one day after surgery ranged from 0.4 (resting position) to 1.6 (coughing) for group 1, and from 0.3 to 1.2 for group 2. Thirty-six percent of the thoracoscopy patients and 33% of the thoracotomy group complained of persistent pain or discomfort on the site of the operation after 3-18 months. CONCLUSION: Post-thoracotomy pain can be effectively controlled with epidural analgesia and pain intensity is no higher than in patients after thoracoscopy who are managed with patient controlled analgesia. FVC is slightly more decreased after thoracotomy during the early postoperative period. FVC and FEV 1 approach the predicted values after four months in both groups. The rate of persistent pain is similar after thoracoscopy and thoracotomy.
Sujets
PID Serval
serval:BIB_7C2C80DE1B9B
PMID
Open Access
Oui
Date de création
2008-01-29T12:00:48.009Z
Date de création dans IRIS
2025-05-21T04:10:04Z