Seminars in Cardiothoracic and Vascular Anesthesia

 

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Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 3, No. 3, 144-155 (1999)
DOI: 10.1177/108925329900300302

The Pharmacology of New Drugs and New Uses for Older Drugs Used for Thoracic Pain Relief

Yaacov Gozal

Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Jerusalem, Israel

Benjamin Drenger

Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Jerusalem, Israel

Thoracotomy results in severe pain and deleterious changes in pulmonary physiology. These alterations are inevitable and can be minimized by effective analgesia. There are many options available for the treatment of postthoracotomy pain. Systemic opioids have been extensively used in this context but their side effects have led to the development of various routes of administration; the epidural route in combination with local anesthetics is the most effective. Other techniques include intercostal nerve block and intrapleural analge sia. Drugs such as clonidine, nonsteroidal anti-inflamma tory drugs, and ketamine are promising for the relief of pain after thoracotomy but further investigations are still warranted.


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