Journal Information
Vol. 27. Issue 8.
Pages 342-345 (November - December 1991)
Share
Share
Download PDF
More article options
Vol. 27. Issue 8.
Pages 342-345 (November - December 1991)
Full text access
Tratamiento del dolor postoracotomía mediante crioanalgesia intercostal intraoperatoria: estudio prospectivo en 80 casos
Treatment of posthoracotomy pain by means of intraoperative intercostal cryoanalgesia: prospective study in 80 cases
Visits
6128
J. Zapatero Gaviria, R. Peñalver Pascual, L. Madrigal Royo, B. Baschwitz Gómez, M. Córdoba Pelaez, J. Candelas Barrios
Servicios de Cirugía Torácica. Hospital Ramón y Cajal. Madrid
R. González Durán**, A. Golpe Gómez*
* Servicios de Neumología. Hospital Ramón y Cajal. Madrid
** Servicios de Unidad del Dolor. Hospital Ramón y Cajal. Madrid
This item has received
Article information

La toracotomía posterolateral representa una de las incisiones quirúrgicas más dolorosas, lo cual conlleva toda una serie de complicaciones importantes. La analgesia idónea continúa siendo un tema controvertido hoy en día, presentando los autores un estudio prospectivo de 80 casos basados en la crioanalgesia intercostal.

Esta técnica resultó efectiva en el 88,75% de la serie (71/ 80), consiguiendo una disminución significativa (p < 0,007) en el consumo de analgésicos no opiáceos. El estudio de la función pulmonar mostraba un incremento de los valores de FVC, FEV1 y PaO2 (p:ns). La incidencia de complicaciones postoperatorias fue más reducida (p < 0,05) al conseguirse una movilización más precoz y más efectiva del hemitórax operado, lo cual se acompaña de una mejor colaboración en la fisioterapia.

Posterolateral thoracotomy is one of the most painful surgical incisions which leads to important complications. The ideal type of anesthesia has not yet been established. The authors report a prospective study in 80 patients who underwent intercostal cryoanalgesia. This technique was considered effective in 71 out of 80 patients (88.75%) since it significantly reduced (p < 0.007) the need for nonopiate analgesics. The study of pulmonary function revealed an increase in FVC, FEV1, and PAO2 (p:NS). Intercostal cryoanalgesia allowed a prompt and effective physical mobilization of the corresponding hemithorax. This ensured a good collaboration of the patient during physiotherapy and this, in turn, lead to a significant (p < 0.05) reduction in postoperative complications.

Full text is only aviable in PDF
Bibliografía
[1.]
W.B. Loan, J.W. Dundee.
The clinical assessment of pain.
Practitioner, 198 (1967), pp. 759-768
[2.]
J.A. Gallo, P.W. Lebowitz, G.E. Battit, J.M.R. Bruner.
Complications of intercostal nerve blocks performed under direct vision during thoracotomy. A report of two cases.
J Thorac Cardiovasc Surg, 86 (1983), pp. 628-630
[3.]
S. Sabanathan, P.B. Bickford Smith, G.N. Pradhan, H. Hashimi, J.B. Eng, A.J. Mearns.
Continuous intercostal nerve block for pain relief after thoracotomy.
Ann Thorac Surg, 46 (1988), pp. 425-426
[4.]
J. Katz.
Cryoanalgesia for post-thoracotomy pain.
Ann Thorac Surg, 48 (1989), pp. 5
[5.]
K.M. Nelson, R.G. Vincent, R.S. Bourke, et al.
Intraoperative intercostal nerve freezing to prevent post-thoracotomy pain.
Ann Thorac Surg, 18 (1974), pp. 280-285
[6.]
J. Herreros, R. Arcas, R. Llorens, R. Martínez Vila, L. Ponz, F. Carrascosa.
Técnica de la criocoagulación de los nervios intercostales para analgesia postoracotomía.
Rev Esp Cir CTV, 2 (1984), pp. 279
[7.]
L.C.H. Muller, G.M. Salzer, G. Ransmayr, A. Neiss.
Intraoperative cryoanalgesia for post-thoracotomy pain relief.
Ann Thorac Surg, 48 (1989), pp. 15-18
[8.]
J. Katz, W. Nelson, R. Forrest, C.L. Bruce.
Cryoanalgesia for post-thoracotomy pain.
Lancet, 1 (1980), pp. 512-513
[9.]
J. Herreros, J. Casares, E. Martínez Vila, et al.
La criocoagulación de los nervios intercostales como analgesia postoracotomía.
Rev Quir Esp, 12 (1985), pp. 153-158
[10.]
M.O. Maiwand, A.R. Makey, A. Rees.
Cryoanalgesia after thoracotomy. Improvement of technique and review of 600 cases..
J Thorac Cardiovasc Surg, 92 (1986), pp. 291-295
[11.]
F. Sebastián, D. Luna, C. Hernández, F. Romay, N. Mugica, P. Teller.
Dolor postoracotomía: criocoagulación o/y neurotripsia, versus infiltración intercostal o/y analgesia general.
Arch Bronconeumol, 24 (1988), pp. 157-160
[12.]
I.D. Conacher, M. Kokri.
Postoperative paravertebral blocks for thoracic surgery. A radiological appraisal.
Br J Anaesth, 59 (1987), pp. 155-161
[13.]
M.D. Mainwand, A.R. Makey.
Cryoanalgesia for relief of pain after thoracotomy.
Br Med J, 282 (1981), pp. 1749-1750
[14.]
D.L. Brown.
Postoperative analgesia following thoracotomy. Danger of delayed respiratory depression..
Chest, 88 (1985), pp. 779-780
[15.]
S.M. Rooney, S. Jain, P. Mc Cormack, M.S. Bains, N. Martin, P.L. Goldiner.
A comparison of pulmonary function tests for post-thoracotomy pain using cryoanalgesia and transcutaneous nerve stimulation.
Ann Thorac Surg, 41 (1986), pp. 204-207
[16.]
J.C. Roxburgh, C.G. Markland, B.A. Ross, W.F. Kerr.
Role of cryoanalgesia in the control of pain after thoracotomy.
Thorax, 42 (1987), pp. 292-295
[17.]
A.G. De la Rocha, K. Chambers.
Pain amelioration after thoracotomy: a prospective randomized study.
Ann Thorac Surg, 37 (1984), pp. 239-242
Copyright © 1991. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?