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La Colla L, Starnari R, Stafford-Smith M. The Epidural "Test Dose" - Time to Rethink Our Thoracic Practice? J Cardiothorac Vasc Anesth 2021; 35:3145. [PMID: 33865682 DOI: 10.1053/j.jvca.2021.02.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Luca La Colla
- Department of Anesthesiology, Duke University Medical Center, Durham, NC
| | - Roberto Starnari
- Department of Anesthesia, Resuscitation and Analgesic, Italian National Research Center on Ageing (IRCCS INRCA), Ancona, Italy
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Bottiger BA, Esper SA, Stafford-Smith M. Pain Management Strategies for Thoracotomy and Thoracic Pain Syndromes. Semin Cardiothorac Vasc Anesth 2013; 18:45-56. [DOI: 10.1177/1089253213514484] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pain after thoracic surgery can be severe and, in the acute phase, contribute to perioperative morbidity and mortality. Unfortunately, patients also incur a significant risk of chronic pain. Although there are guidelines for postoperative pain management in these patients, there is no widespread surgical or anesthetic “best practice.” Here, we review the recent literature on techniques specific to perioperative pain control for thoracic patients, including medical management, neuraxial blockade, and other regional techniques, and suggest an algorithm for developing a multimodal pain management strategy.
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