Influence of pain on postoperative ventilatory disturbances. Management and expected benefits |
| |
| Affiliation: | 1. Departamento de Reumatología, Centro Médico Nacional Siglo XXI IMSS, México DF, México;2. Departamento de Neumología, Centro Médico Nacional Siglo XXI IMSS, México DF, México;3. Departamento de Medicina Interna, Hospital Angeles del Pedregal, México DF, México;4. Departamento de Reumatología, Hospital General de Cuernavaca, México DF, México;1. Université de Bordeaux, adaptation cardiovasculaire à l’ischémie, U1034, 33600 Pessac, France;2. Inserm, adaptation cardiovasculaire à l’ischémie, U1034, 33600 Pessac, France;3. Service d’anesthésie-réanimation II, maison du Haut-Lévêque, groupe hospitalier Sud, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France;4. Université de Bordeaux, bioingénierie tissulaire, U1026, 33000 Bordeaux, France;1. Department of Physical Medicine and Rehabilitation, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea;2. Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea;3. Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea;4. Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea;1. Département d’anesthésie-réanimation de St-Éloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France;2. Inserm U1046, université Montpellier 1, 34000 Montpellier, France;3. Département d’anesthésie et réanimation, hôpital Estaing, université de Clermont-Ferrand, 1, rue Lucie-Aubrac, 63100 Clermont-Ferrand, France |
| |
| Abstract: | Abdominal surgery induces postoperative ventilatory dysfunction related to a combination of reflex diaphragmatic inhibition, respiratory muscle injury and pain. The role of pain is difficult to isolate from other components. Thoracic epidural analgesia using local anesthetics is able to partially reverse the diaphragmatic dysfunction. However, this effect seems not directly related to analgesia. Regardless of the mechanisms, epidural analgesia has been shown to improve the postoperative ventilation and to prevent the occurrence of pulmonary complications. Pain relief, either by parenteral administration of opiate, and/or parietal blockade has been shown to improve the diaphragm motion and the overall respiratory status. All analgesic strategies may facilitate the implementation of postoperative physiotherapy which has a significant interest in preventing postoperative pulmonary complications. |
| |
| Keywords: | Pulmonary complications Epidural analgesia Abdominal surgery Postoperative pain Complications pulmonaires Analgésie péridurale Chirurgie abdominale Douleur postopératoire |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
