Abstract
The hemiclamshell incision is a valid but infrequent surgical alternative for the resection of tumors from mediastinum. This point makes this approach impossible to be studied under a randomized controlled trial. The triple association of thoracotomy, sternotomy and cervicothomy makes the hemiclamshell approach a high intensity postoperative pain surgery. However, there is no published data on this topic, and the reviewed articles only mention the analgesic regimens as a secondary point. Indeed, no author defines the best epidural drugs mixture for the patients. Multimodal analgesic regimen based on regional anesthesia should be used. Based on the recent advances on spinal opioids, morphine could be a good choice as epidural coadjutant to local anesthetics for hemiclamshell incision.
Highlights
Classical incisions, such as postero-lateral thoracotomy or median sternotomy, do not provide optimal exposure of the intraoperative field for surgical treating of tumors arising from the cervico-thoracic junction or in the anterior mediastinum with extension to the chest cavity [1]
Most of them, focusing on the thoracic surgeon choice of the most appropriate surgical approach to obtain complete tumor resection and repair of damaged structures but not on the management of postoperative pain. This one should be treated with a multimodal analgesic regimen based on continuous thoracic epidural analgesia but the best choice for epidural drugs mixture has not been yet well defined [13]
We present the case of a young man, which was treated with thoracic epidural bupivacaine plus morphine during 72 hours for the treat
Summary
Classical incisions, such as postero-lateral thoracotomy or median sternotomy, do not provide optimal exposure of the intraoperative field for surgical treating of tumors arising from the cervico-thoracic junction or in the anterior mediastinum with extension to the chest cavity [1]. Most of them, focusing on the thoracic surgeon choice of the most appropriate surgical approach to obtain complete tumor resection and repair of damaged structures but not on the management of postoperative pain. This one should be treated with a multimodal analgesic regimen based on continuous thoracic epidural analgesia but the best choice for epidural drugs mixture has not been yet well defined [13]. Ment of postoperative pain after hemiclamshell incision for the resection of a mediastinal Castleman disease This approach was successfully accepted either by the patient or the multidisciplinary medical and nursing team
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
