الفهرس | Only 14 pages are availabe for public view |
Abstract The aim of this study is to compare the effect of preoperative ultrasound guided suprascapular nerve block (SNB) and intra-operatveperiphrenic-fat-pad infiltration(PNI) with local anesthetics for ipsilateral shoulder pain(ISP) after thoracic surgery. In conclusion: Ipsilateral shoulder pain after thoracotomy is common and may be severe. The most likely explanation is that irritation of the pericardium, and mediastinal and diaphragmatic pleural surfaces result in pain transferred to the shoulder via the phrenic nerve. Infiltration of the phrenic nerve at the level of the diaphragm significantly reduces the incidence of shoulder pain compared to suprascapular nerve block. The combination of epidural and ipsilateral phrenic nerve blocks therefore approaches the ideal goal of pain-free thoracotomy, and PNI should be performed in all patients undergoing thoracotomy for major lung resection surgery |