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Abstract
Pain from thoracotomy incision is considered to be severe and intense as a consequence of tissue damage to the ribs, muscles and peripheral nerves. So; in addition to loss of lung tissue and pulmonary reserve, thoracotomy patients experience painful wound incision that alter chest wall mechanics. Ineffective chest expansion may predispose to atelectasis, ventilation/perfusion mismatching, hypoxemia, and infection.
The provision of pain relief has been crucial in decreasing morbidity due to pulmonary complications and attenuating the stress response.
Thoracic epidural analgesia is often regarded to be the gold standard for post-thoracotomy pain relief. Many clinical studies concluded that thoracic epidural analgesia was superior to intercostals, interpleural, and I.V. opioids analgesia after thoracotomy.
However, epidural analgesia is not always ideal, and carries some risks such as dural perforation, bleeding, infection, hypotension, bradycardia, and urinary retention. Other useful regional methods of analgesia after thoracotomy have been proposed.