Multidisciplinary approach in management of postoperative pain in modern thoracic surgery
Aim. To analyze state of the art methods of management of postoperative pain in patients who undergone thoracic operations. Materials and methods. Thoracotomy still remains basic approach in general thoracic surgery especially on extended and combined interventions on the chest organs. In the same time thoracotomy is one of the most traumatic approaches to surgery. There are a lot of approaches in complex anesthesia after thoracotomy in present time, but there is no single standard. Various clinics have their own protocols in anesthesia in the early postoperative period, according to internal approach. Results. The formation of persistent pain syndrome in the distant period can form up to 22.5% of cases and its occur very important difficult problem of modern thoracic surgery. The development of resistant pain syndrome in the early postoperative period can cause the development of complications in the cardiovascular system (with the occurrence of arrhythmias, acute coronary syndrome, cardiovascular insufficiency). Due to the limited mobility of the chest, there may also develop complications from the respiratory system (impaired sputum evacuation in the tracheobronchial tree, reduced respiratory volumes, progression of respiratory failure). Conclusion. Inadequate analgesia after thoracotomy is an extremely important issue and requires a multimodal approach. Successful anesthesia is possible only with the participation of specialists in various fields: surgeons, anesthesiologists, physiotherapists, etc. In our work, an analysis of modern methods of anesthesia in patients of the thoracic profile was conducted, including the following: systemic anesthesia, regional anesthesia methods, nerve terminal blockade, local anesthesia, lymphotropic anesthetics, options for thoracotomy closure.