EFFECT OF ABSORBABLE SUTURES ON POST THORACOTOMY PAIN THE SEQUEL OF NERVE ENTRAPMENT.

Farooq Ahmad Ganie,G N Lone,Mohd Yaqoob Khan,Rouf Gul,Syed Wahid

doi:10.32553/ijmbs.v4i6.1192

Abstract

Objective: To study the effect of use of absorbable suture material in thoracotomy closure on the chronic post-thoracotomy pain. Keywords: Open thoracotomy, Nerve entrapment, Persistent pain, Absorbable suture

Highlights

The International Association for the Study of Pain (IASP) defines post thoracotomy pain as symptoms of pain occurring within the area of the thoracotomy incision and persisting for at least two months or more following the surgical procedure.[1]
Considerable efforts have been directed toward reducing the intensity of acute post-thoracotomy pain, based on the assumption that acute pain is a predictive factor for chronic pain.[7]
Among the 50 patients having their thoracotomy closed by non-absorbable suture, an alarming number of 42 (84%) patients had severe persistent post thoracotomy pain even after 2 years, seldom relieved by analgesics. 6(12%) of the patients complained of bearable thoracotomy site pain, that did not affect their quality of life

Summary

Introduction

The pain that occurs following a thoracotomy procedure, which is known as post thoracotomy pain, is quite commonly very severe [1] and uncontrolled pain can have negative consequences and transition to chronic pain.[2]. Considerable efforts have been directed toward reducing the intensity of acute post-thoracotomy pain, based on the assumption that acute pain is a predictive factor for chronic pain.[7] Because post-thoracotomy pain shows many neuropathic components,[8] it is likely that intercostal nerve injury or entrapment plays a key role in the development of this condition. Many investigators have reported improvement in postoperative pain by using nerve-sparing techniques, such as intercostal suturing, edge-to-edge sutures, and protection of the intercostal nerve by mobilizing the intercostal bundle.[13] suggesting either the direct injury or the entrapment of the intercostal nerve bundle With this consideration, we attempted to assess the validity of suture entrapment of intercostal nerve during thoracotomy closure and the advantages of release of entrapment after the absorbable suture gets removed

Material & Methods

Results

Discussion

Conclusion

Intercostal