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  • Title: Incidence of post-thoracotomy pain: a comparison between total intravenous anaesthesia and inhalation anaesthesia.
    Author: Song JG, Shin JW, Lee EH, Choi DK, Bang JY, Chin JH, Choi IC.
    Journal: Eur J Cardiothorac Surg; 2012 May; 41(5):1078-82. PubMed ID: 22290901.
    Abstract:
    OBJECTIVES: Thoracotomy is one of the most painful surgical incisions. Little is known, however, about the effect of type of anaesthesia on chronic post-thoracotomy pain syndrome (CPTS). We therefore compared the incidence of CPTS after total intravenous anaesthesia (TIVA) and inhalation anaesthesia. METHODS: Patients (n = 366) were prospectively randomized into two groups: Group I (n = 173) received TIVA (propofol + remifentanil) and Group II (n = 170) received inhalation anaesthesia with sevoflurane. We assessed acute pain on postoperative days 1, 3 and 5, and the prevalence of CPTS at 3 and 6 months using a numerical rating scale (NRS). RESULTS: The prevalence of CPTS was significantly lower in patients receiving TIVA than in those receiving inhalation anaesthesia at 3 months (38.2% versus 56.5%, P = 0.001) and at 6 months (33.5% versus 50.6%, P = 0.002), respectively. Moreover, allodynia-like pain was significantly less common in the TIVA group at 3 (P = 0.021) and 6 months (P = 0.032). NRS score of acute pain, however, did not differ significantly between the two groups. CONCLUSIONS: TIVA with propofol and remifentanil may reduce the incidence of CPTS at 3 and 6 months.
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