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Review
. 2023 Aug;23(8):295-303.
doi: 10.1016/j.bjae.2023.05.001. Epub 2023 Jun 22.

Regional analgesia for acute pain relief after open thoracotomy and video-assisted thoracoscopic surgery

S Mehta  1 , T T H Jen  2   3 , D L Hamilton  4   5
Affiliations
Review

Regional analgesia for acute pain relief after open thoracotomy and video-assisted thoracoscopic surgery

S Mehta et al. BJA Educ. 2023 Aug.
No abstract available

Keywords: analgesia; nerve block; pain; postoperative; thoracotomy.

PubMed Disclaimer

Conflict of interest statement

DLH is an editor and editorial board member of BJA Education. The other authors declare that they have no conflicts of interest.

Figures

Fig 1
Fig 1
Transverse section through the thorax at the level of the third thoracic vertebra (T3) showing innervation of the thoracic wall and targets for thoracic fascial plane blocks. Muscles: ESM, erector spinae; Ext IM, external intercostal; Inn IM, innermost intercostal; Int IM, internal intercostal; Pec, pectoralis. Regional block targets: ESP, erector spinae plane; MTP, mid-point transverse process to pleura block; RISS, Rhomboid intercostal and subserratus plane; RLB, retrolaminar block; SAP, serratus anterior plane; TPVB, thoracic paravertebral block. Modified from FitzGerald and colleagues (2019).
Fig 2
Fig 2
Sonographic imaging for erector spinae plane block (A and B) and serratus anterior plane block (C and D). ES, erector spinae; IC, intercostal muscles; ITC, intertransverse tissue complex; LD, latissimus dorsi; SA, serratus anterior; Rm; rhomboid major, TP, transverse process, Tr, Trapezius. Dotted line, pleura; dashed line, erector spinae plane (B) and superfical SAP (D). The thoracodorsal artery is shown in red.
Fig 3
Fig 3
Algorithm for regional analgesia options for VATS as outlined by PROSPECT Recommendations for Video-Assisted Thoracoscopic Surgery 2021. VATS, video-assisted thoracoscopic surgery.
Fig 4
Fig 4
Proposed algorithm for regional analgesic options for open thoracotomy. Adapted from PROSPECT Recommendations for Thoracotomy 2015. ICNB, intercostal nerve block; LA, local anaesthetic.
See this image and copyright information in PMC

References

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