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Pain Management 2016
October 03-04, 2016
Volume 5, Issue 5(Suppl)
J Pain Relief
ISSN: 2167-0846 JPAR, an open access journal
conferenceseries
.com
October 03-04, 2016 Vancouver, Canada
International Conference on
Pain Research & Management
J Pain Relief 2016, 5:5(Suppl)
http://dx.doi.org/10.4172/2167-0846.C1.012Efficacy of paravertebral block analgesia for post-thoracotomy pain control
Montaser Elsawy Abd Elaziz
Menoufia University, Egypt
P
aravertebral block (PVB) is an effective analgesic technique for post-thoracotomy pain, whereas there is no clear proof on
how it can be more effective. We aimed to assess if the pleural integrity has a significant effect on thoracic PVB analgesia.
Data of patients who underwent thoracotomy and paravertebral catheterization at the Menoufia University Hospitals, between
November 2010 and December 2014 were retrospectively collected. Patients were classified into two groups; Group A, where
the parietal pleura was disrupted, and Group B, where there was no pleural tear. Pain scores and pulmonary functions were
compared between both groups. Also, the frequency of PVB analgesia and the need for supplementary drugs taken as well as
the use of rescue pain medications were assessed in both groups. 132 patients were analyzed; group A (n=68) patients with
pleural disruption and group B (n=64) patients with intact pleural. There was no statistical significant difference regarding age,
sex, body mass index, American society of anesthesiologists score (ASA), diagnosis, and operative details. Pain scores were
significantly lower in Group B, where no there was no pleural tear. Pulmonary functions significantly improved among intact
pleura group. Significant increase in the frequency of PVB analgesia, supplementary drugs taken in postoperative period and
in the use of rescue drugs were observed in patients with pleural disruption. Complications were higher in pleural disruption
group. Preservation of integrity of the parietal pleura is essential for the quality thoracic PVB.
mnt_swy@yahoo.comThe trends and challenges of pain management in the Neonatal Intensive Care Unit
Nadja Bressan
The Hospital for Sick Children, Canada
C
ritically ill immature preterm infants experience multiple noxious stimuli while receiving care in the Neonatal Intensive
Care Unit (NICU). These noxious stimuli include, but are not limited to: venipuncture; insertion of intravenous and
arterial catheters; suctioning of the nose, mouth and oropharynx; endotracheal intubation for mechanical ventilation; insertion
of chest drains; and repositioning and other types of patient manipulation. The delivery of optimal doses of analgesics for these
noxious stimuli is a major challenge due to the lack of knowledge about drug disposition and its effects in this population.
Beyond the lack of knowledge for dose selection and response prediction, it is also relevant to consider the clinical importance
of new consequences of analgesic use such as opioid-induced tolerance, hyperalgesia drug related toxicities and neonatal drug
discontinuation syndrome, which challenge the current paradigm for pain management in the newborn infant population.
In addition, the impact of pain in the neurodevelopment aligned to fast development of the immature brain increase the
complexity in the evaluation of nociception/pain. The drug therapy used in pain management relies on an adequate pain
assessment of the preterm neonate. The development of computational algorithms to measure nociception/pain in real-time
constitutes the next step for pain management in the NICU. An efficient evaluation system may decrease the uncertainty on
drug dosage, increase patient safety and improve pain management addressing the impact of pain in the immature brain and
explain the neurologic pathway of pain in preterm infants.
nadja.bressan@sickkids.ca