Abstract
Thoracic surgery is known to cause severe pain that may not subside during the course of hospitalization. Early pain control is important in these patients because it improves ventilation and promotes mobility. Lung transplant recipients can experience post-operative complications that lead to extended hospital stays. This increases the time a patient is sedentary, which further deconditions patients; therefore, rehabilitation should be initiated early post-operatively. We present a unique case of a critically ill double lung transplant recipient whose rehabilitation post-operatively was hindered by severe vasopressor-induced ischemic pain. Due to debilitating pain, he was unable to regain mobility. His pain management course was challenging due to sensitivity to opioids, renal failure, and anticoagulation.
Highlights
We present a unique case of a critically ill double lung transplant recipient whose rehabilitation post-operatively was hindered by severe vasopressor-induced ischemic pain
Bilateral lung transplant recipients receive bilateral thoracosternotomy incisions that are associated with severe pain
We present a unique case of complex pain management in a critically ill lung transplant recipient who was sensitive to opioids, had renal failure, and was on anticoagulation
Summary
Bilateral lung transplant recipients receive bilateral thoracosternotomy (clamshell) incisions that are associated with severe pain. It can lead to devastating functional consequences, especially in the limbs When surgical interventions such as debridement, amputation, and/or revascularization are not indicated, the main goal is treating the symptoms through pain management. We present a unique case of complex pain management in a critically ill lung transplant recipient who was sensitive to opioids, had renal failure, and was on anticoagulation. His significant pain limited his recovery post-operatively, and our inpatient pain management service played an integral role in his recovery
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