BACKGROUND: Patients undergoing thoracic surgery frequently suffer from chronic pain after thoracotomy. Chronic can lead to a significant decline in patient’s quality of life. However, the effect single-shot paravertebral block (TPVB) combined with intravenous analgesia on incidence is unclear. OBJECTIVE: The objective was evaluate impact TPVB versus continuous epidural (TEA) STUDY DESIGN: A ra...

Introduction The pathway of a pain impulse starts with the primary afferent nerve fibers (C and Aδ) whose axons end in the dorsal horn of the spinal cord. Nociceptive information is passed to the contralateral side of the spinal cord and, after synapsing, ascends in the anterolateral system as spinothalamic tracts. The primary areas of the brain that respond to pain stimuli are the somatosensor...

The necessity for prehospital thoracotomy is rare, but can be lifesaving. Occasionally an emergency practitioner or surgeon coincidentally arrives at a trauma scene before the arrival of emergency medical teams. In such a circumstance, even when thoracotomy may be indicated, it is not usually performed in view of the lack of equipment (e.g., dissecting tools or rib retractor). We present a nove...

BACKGROUND Nonthoracotomy-implantable cardioverter/defibrillator (ICD) systems may represent a significant advance in the treatment of patients with life-threatening ventricular arrhythmias, but their merits relative to those of the well-established thoracotomy systems remain largely unknown. The objective of this study was to compare the short- and long-term clinical outcomes after attempted I...

Trans-sternal bilateral thoracotomy was performed to resect the right upper lobe and the left S1 + 2 + S3, and to complete lymphadenectomy in a 35-year-old female case of lung cancer in whom multiple lesions were suspected. Trans-sternal bilateral thoracotomy was considered to be useful for one-stage surgery in patients in whom bilateral lung cancer is suspected or confirmed, because it provide...

OBJECTIVE To describe patient selection criteria, surgical technique and early outcomes in patients undergoing reoperative coronary artery bypass surgery (RECABG) through a left thoracotomy without cardiopulmonary bypass (CPB). METHODS Eight patients with patent grafts to the anterior interventricular branch of left coronary artery (four of which had also patent grafts to the right coronary a...

Methods Between January 2001 and May 2013 thirty patients underwent redo off-pump CABG from descending aorta to circumflex artery and branches via left thoracotomy at our hospital. Of the thirty patients, 26 were male (86.6%) and 4 were female (13.4%) with a mean age of 60.5 years. All patients had patent LIMA-LAD anastomosis. Left thoracotomy was performed through the fifth intercostal space. ...

Pain control is a major concern in post-thoracotomy patients. The current prospective randomized double-blind study was designed to evaluate the analgesic effects of morphine and fentanyl given interpleurally after posterolateral thoracotomy. Thirty patients undergoing elective posterolateral thoracotomy in a teaching hospital in Tehran were divided into 3 groups with equal number of patients. ...