PAIN TREATMENT AFTER THORACOTOMY - IS IT A SPECIAL PROBLEM

Background. Although it is frequently stated in the literature that th oracotomy is one of the most painful operative incisions, few data sup porting this view are available. Methods. Patients' postoperative pain experience can be assessed on the basis of their usage of patient-con trolled analgesia. In a prospective trial the daily self-administered doses of analgesics in 55 patients within the first 4 days after poste rolateral thoracotomy were compared with those in 30 patients for the same number of days after median laparotomy. The visual analog scale w as used as a second measure to evaluate postoperative pain. Results. O n the basis of patient-controlled analgesia usage on the first postope rative day and the visual analog scale score for the first 2 days, a s mall but significant difference between the two patient groups was fou nd which showed that thoracotomy is less painful than median laparotom y. Conclusions. The common belief that posterolateral thoracotomy is a very painful operative access is not true. Therefore it is not necess ary to use special techniques for postthoracotomy pain relief in these patients. Patient-controlled analgesia is sufficient for pain relief after major thoracic or abdominal incisions. (C) 1997 by The Society o f Thoracic Surgeons.