Articles

Effect of Cryoanalgesia on Post-Thoracotomy Pain

Abstract

We prepared this study to determine the effect of cryoanalgesia on post-thoracotomy pain. In this double-blinded randomized clinical trial, 60 patients who underwent thoracotomy were divided into two groups (control and cryoanalgesia). Visual Analogue Scale (VAS, 0-10) was used for the measurement of severity of post-thoracotomy pain. It was classified into three categories: 0-1 (mild), 2-3 (moderate), and 4-10 (severe). Pethidine (0.5-1 mg/kg) was administered in case of need for both groups. Patients were visited at the hospital a week later, and were contacted by phone at the first, second, and third months post-operatively. Intensity of pain in the control group was higher than the cryoanalgesia group in all visits the follow-up period. On the second day, the frequencies of severe pain (4-10) were 33.3% and 0 in the control and cryoanalgesia groups, respectively. The mild pain on the seventh day was 13.3% and 83.3% in the control and cryoanalgesia groups, respectively (P < 0.01). Pethidine consumption was 151.6 ± 27 mg in the control group and 87.5 ±48 mg in the cryoanalgesia group on the first day post-operation (P < 0.001). Cryoanalgesia is a useful technique with not serious side effects in order to alleviate post-thoracotomy pain and reduce the need for opiate consumption.

Loan WB, Dundee JW. The clinical assessment of pain. Practitioner 1967;198(188):759-68.

Papper EM, Brodie BB, Rovenstine EA. Postoperative pain; its use in the comparative evaluation of analgesics. Surgery 1952;32(1):107-9.

Ju H, Feng Y, Yang BX, Wang J. Comparison of epidural analgesia and intercostal nerve cryoanalgesia for postthoracotomy pain control. Eur J Pain 2008;12(3):378-84. Epub 2007 Sep 17.

Senturk M. Acute and chronic pain after thoracotomies. Curr Opin Anaesthesiol 2005;18(1):1-4.

Perkins FM, Kehlet H. Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology 2000;93(4):1123-33.

Karmakar MK, Ho AM. Postthoracotomy pain syndrome. Thorac Surg Clin 2004;14(3):345-52.

Dajczman E, Gordon A, Kreisman H, Wolkove N. Longterm postthoracotomy pain. Chest 199; 99(2):270-4.

Perttunen K, Tasmuth T, Kalso E. Chronic pain after thoracic surgery: a follow-up study. Acta AnaesthesiolScand 1999;43(5):563-7.

Wallace AM, Wallace MS. Postmastectomy and postthoracotomypain. Anesthesiol Clin North Am 1997;15:353-70.

Miller RD, editor. Miller's Anesthesia. 6th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2005: p. 1722.

Cousins MJ, Bridenbaugh PO. Neural Blockade in Clinical Anesthesia and Management of Pain. 3rd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 1998.

Todd KH, Funk KG, Funk JP, Bonacci R. Clinical significance of reported changes in pain severity. Ann Emerg Med 1996;27(4):485-9.

Miguel R, Hubbell D. Pain management and spirometry following thoracotomy: a prospective, randomized study of four techniques. J Cardiothorac Vasc Anesth 1993;7(5):529-34.

Trescot AM. Cryoanalgesia in interventional pain management. Pain Physician 2003;6(3):345-60.

Müller LC, Salzer GM, Ransmayr G, Neiss A. Intraoperative cryoanalgesia for postthoracotomy pain relief. Ann Thorac Surg 1989;48(1):15-8.

Brichon PY, Pison C, Chaffanjon P, Fayot P, Buchberger M, Néron L, et al. Comparison of epidural analgesia and cryoanalgesia in thoracic surgery. Eur J Cardiothorac Surg 1994;8(9):482-6.

Maiwand MO, Makey AR, Rees A. Cryoanalgesia after thoracotomy. Improvement of technique and review of 600 cases. J Thorac Cardiovasc Surg 1986;92(2):291-5.

Orr IA, Keenan DJ, Dundee JW. Improved pain relief after thoracotomy: use of cryoprobe and morphine infusion. Br Med J (Clin Res Ed) 1981;283(6297):945-8.

Pastor J, Morales P, Cases E, Cordero P, Piqueras A, Galán G, et al. Evaluation of intercostal cryoanalgesia versus conventional analgesia in postthoracotomy pain. Respiration 1996;63(4):241-5.

Kalichman MW, Myers RR. Behavioral and electrophysiological recovery following cryogenic nerve injury. Exp Neurol 1987;96(3):692-702.

Files
IssueVol 49, No 4 (2011) QRcode
SectionArticles
Keywords
Cryoanalgesia Pain Thoracotomy

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Momenzadeh S, Elyasi H, Valaie N, Radpey B, Abbasi A, Nematollahi F, Mohammadinasab H. Effect of Cryoanalgesia on Post-Thoracotomy Pain. Acta Med Iran. 1;49(4):241-245.