Post-thoracotomy ipsilateral shoulder pain: What should be preferred to optimize it - phrenic nerve infiltration or paracetamol infusion?

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dc.contributor.authorManzoor, Sobiaen_US
dc.contributor.authorKhan, Taliben_US
dc.contributor.authorZahoor, Syed Ameren_US
dc.contributor.authorWani, Shaqul Qamaren_US
dc.contributor.authorRather, Jan Mohamaden_US
dc.contributor.authorYaqoob, Shaistaen_US
dc.contributor.authorAli, Zulfiqaren_US
dc.contributor.authorHakeem, Zubair Ashrafen_US
dc.contributor.authorDar, Bashir Ahmaden_US
dc.date.accessioned2019-12-02T09:44:18Z
dc.date.available2019-12-02T09:44:18Z
dc.date.issued2019-07
dc.description.abstractBackground: Post thoracotomy ipsilateral shoulder pain (PTISP) is a distressing and highly prevalent problem after thoracic surgery and has not received much attention despite the incidence as high as 85%. Objectives: To study the effect of phrenic nerve infiltration with Ropivacaine compared to paracetamol infusion on PTISP in thoracotomy patients with epidural analgesia as standard mode of incisional analgesia in both the groups. Study Design: Prospective Randomised and Double Blind Study. Methods: 126 adult patients were divided randomly into 2 groups, “Group A (Phrenic Nerve Infiltration Group) received 10 mL of 0.2% Ropivacaine close to the diaphragm into the periphrenic fat pad” and “Group B (Paracetamol Infusion Group) received 20mg/kg paracetamol infusion” 30 minutes prior to chest closure respectively. A blinded observer assessed the patients PTISP using the VAS score at 1, 4, 8, 12 and 24 hours (h) postoperatively. The time and number of any rescue analgesic medication were recorded. Results: PTISP was relieved significantly in Group A (25.4℅) as compared to Group B (61.9℅), with significantly higher mean duration of analgesia in Group A. The mean time for first rescue analgesia was significantly higher in Group A (11.1 ± 7.47 hours) than in Group B (7.40 ± 5.30 hours). The number of rescue analgesic required was less in Group A 1.6 ± 1.16 as compared to Group B 2.9 ± 1.37 (P value <0.5). Conclusions: Phrenic Nerve Infiltration significantly reduced the incidence and delayed the onset of PTISP as compared to paracetamol infusion and was not associated with any adverse effects.en_US
dc.identifier.affiliationsDepartment of Anaesthesiology, Pain and Critical Care, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, Indiaen_US
dc.identifier.affiliationsDepartment of Anaesthesiology, Pain and Critical Care; Division of Cardiovascular and Thoracic Anaesthesia and Cardiac SICU, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, Indiaen_US
dc.identifier.affiliationsDepartment of Radiation Oncology, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, Indiaen_US
dc.identifier.affiliationsDepartment of General Surgery, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, Indiaen_US
dc.identifier.affiliationsDepartment of Cardiovascular and Thoracic Surgery, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, Indiaen_US
dc.identifier.citationManzoor Sobia, Khan Talib, Zahoor Syed Amer, Wani Shaqul Qamar, Rather Jan Mohamad, Yaqoob Shaista, Ali Zulfiqar, Hakeem Zubair Ashraf, Dar Bashir Ahmad. Post-thoracotomy ipsilateral shoulder pain: What should be preferred to optimize it - phrenic nerve infiltration or paracetamol infusion?. Annals of Cardiac Anaesthesia. 2019 Jul; 22(3): 291-296en_US
dc.identifier.issn0971-9784
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/185826
dc.languageenen_US
dc.publisherWolters Kluwer - Medknowen_US
dc.relation.issuenumber3en_US
dc.relation.volume22en_US
dc.source.urihttps://dx.doi.org/10.4103/aca.ACA_76_18en_US
dc.subjectParacetamolen_US
dc.subjectphrenic nerve infiltrationen_US
dc.subjectpost‑thoracotomy ipsilateral shoulder painen_US
dc.subjectpost thoracotomy painen_US
dc.subjectropivacaineen_US
dc.subjectthoracic epidural analgesiaen_US
dc.titlePost-thoracotomy ipsilateral shoulder pain: What should be preferred to optimize it - phrenic nerve infiltration or paracetamol infusion?en_US
dc.typeJournal Articleen_US
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