Pain control after thoracic surgery is vital for the patient's recovery, as pain reduction contributes to improved respiratory function, prevention of complications and a faster return to daily activities. Thoracic surgeries, whether open (thoracotomy) or minimally invasive (thoracoscopic or robotic), can cause pain due to injury to tissues, nerves or even ribs.

Pain Control Methods

1. Adjunctive Analgesic Techniques Medication is the cornerstone of pain management. It relies on a combination of medications for greater effectiveness and minimizing side effects:

• Non-Opioid Analgesics: Medications such as paracetamol (e.g. Depon, Apotel) and non-steroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and pain. They are suitable for mild to moderate pain.
• Opioid Analgesics: In exceptional cases of severe pain, opioids, such as morphine, pethidine and fentanyl, are administered intravenously. narrow medical monitoring to manage pain that does not respond to other treatments.
• Neuropathic Analgesics: Medications such as gabapentin or pregabalin are administered to relieve neuropathic pain, particularly when the intercostal nerves have been injured.

2. Nervous Blockages Nerve blocks are an extremely effective method of pain relief, especially after major thoracic surgeries:

• Neuroaxonal Exclusion: Analgesic solution is injected into the epidural country of the spine, offering long-lasting pain relief.
• Intercostal Blockades: Local anesthetics are administered along the intercostal nerves to relieve chest wall pain.

3. Peripheral Analgesia Techniques

• Peripheral Nerve Catheters: They are placed close to the wound site and continuously deliver small doses of local anesthetics, reducing the need for opioids.
• Local Anesthetic Infiltration: Anesthetics are injected directly around the wound for immediate and targeted analgesia.

4. Minimally Invasive Procedures Thoracoscopic and robotic surgical techniques minimize tissue trauma and, consequently, postoperative pain. The smaller incision and less destruction of the chest wall contribute to reduced pain intensity and faster recovery.
5. Non-Pharmaceutical Methods

• Physiotherapy and Breathing Exercises: They help improve mobility and prevent complications such as pneumonia.
• Psychological Support: Educating patients about pain and available treatments reduces anxiety and enhances pain tolerance.
• Cold or Hot Applications: They can reduce inflammation and relieve discomfort in the wound area.

Benefits of Adequate Pain Management

Appropriate pain management reduces the risk of postoperative complications, such as pulmonary atelectasis or thrombosis, as it allows patients to mobilize and perform deep breathing exercises. It also enhances quality of life and accelerates recovery, allowing the fastest and safest return in normal activities. Pain management should be individualized for each patient, with a combination of pharmaceutical and non-pharmacological methods, and closely monitored by the medical team to adjust treatment as needed.