Pain management strategies for thoracotomy and thoracic pain syndromes

Semin Cardiothorac Vasc Anesth. 2014 Mar;18(1):45-56. doi: 10.1177/1089253213514484. Epub 2013 Dec 12.


Pain after thoracic surgery can be severe and, in the acute phase, contribute to perioperative morbidity and mortality. Unfortunately, patients also incur a significant risk of chronic pain. Although there are guidelines for postoperative pain management in these patients, there is no widespread surgical or anesthetic "best practice." Here, we review the recent literature on techniques specific to perioperative pain control for thoracic patients, including medical management, neuraxial blockade, and other regional techniques, and suggest an algorithm for developing a multimodal pain management strategy.

Keywords: analgesia; minimally invasive surgery; outcome; postoperative care; thoracic surgery.

Publication types

  • Review

MeSH terms

  • Acute Pain / etiology
  • Acute Pain / therapy
  • Algorithms
  • Anesthetics / administration & dosage
  • Chronic Pain / etiology
  • Chronic Pain / therapy
  • Humans
  • Pain, Postoperative / therapy*
  • Practice Guidelines as Topic
  • Syndrome
  • Thoracic Surgical Procedures / adverse effects*
  • Thoracic Surgical Procedures / methods
  • Thoracotomy / adverse effects*
  • Thoracotomy / methods


  • Anesthetics