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Häufigkeit und Intensität von chronischen Schmerzen nach offenen thoraxchirurgischen Eingriffen - eine Analyse verschiedener Einflussfaktoren wie Alter, Geschlecht, Anästhesie und OP-Verfahren

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Veröffentlichung
2014-11-20
DOI
10.18725/OPARU-3467
Dissertation


Authors
Vogt, Miriam
Faculties
Medizinische Fakultät
License
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https://oparu.uni-ulm.de/xmlui/license_v3
Abstract
Background: Thoracotomy is often necessary for major lung surgery. Unfortunately chronic pain after thoracotomy called post-thoracotomy-pain is not rare but the exact frequency is not known. Determinants like gender, age, preoperative pain etc. are discussed in former studies without a clear etiological correlation with post-thoracotomy pain. Methods: The study was designed as a monocentre, open labelled, randomized observational trial. A total of 92 patients undergoing elective lung surgery were randomly assigned to the epidural (n = 47) or intercostal group (n = 45). 83 patients completed the study. NRS and activity score were assessed preoperatively, during the first 4 postoperative days and 1, 3, 6 and 12 months after anterolateral thoracotomy. Results: At rest 15 % had pain (NRS > 0) preoperatively. One month after surgery 50 % had pain. One year after surgery 16,1 % are still suffering pain at rest. During coughing 22,5 % had pain preoperatively; 61,9 % one month after surgery. One year after thoracotomy 15 % are still suffering pain during coughing. Only a few patients had severe pain (NRS > 3). Regarding the gender significant more women than men had pain during coughing preoperatively (p = 0,028) and one year after surgery (p = 0,023). Regarding age significant more patients < 65 years had pain at rest preoperatively (p = 0,025) and tendentially 6 months after surgery. Patient activity levels are significant lower in those patients with NRS > 3 than those without pain (NRS = 0) 6 months after thoracotomy (p = 0,015). Conclusions: All in all the frequency of post-thoracotomy-pain in this study is low in comparison to earlier studies. With regard to gender and age significant more women and patients < 65 years are still suffering pain preoperatively and one year after thoracotomy. Patient activity levels 1 year after surgery were less than preoperative levels.
Date created
2013
Subject Headings
Thoraxchirurgie [GND]
Thoracic surgery [MeSH]
Keywords
Activity score; Intercostal nerve block; NRS; Post-thoracotomy pain; Thoracic epidural anesthesia
Dewey Decimal Group
DDC 610 / Medicine & health

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Vogt, Miriam (2014): Häufigkeit und Intensität von chronischen Schmerzen nach offenen thoraxchirurgischen Eingriffen - eine Analyse verschiedener Einflussfaktoren wie Alter, Geschlecht, Anästhesie und OP-Verfahren. Open Access Repositorium der Universität Ulm. Dissertation. http://dx.doi.org/10.18725/OPARU-3467

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