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The aim of this study is to evaluate the effect of partial rib resection in reducing acute post-thoracotomy pain
It is known that severe post thoracotomy pain can be reduced by half with some strategies to prevent pain development. It was thought that partial rib resection would reduce intercostal tension and prevent an uncontrolled fracture. Thus, it is argued that post thoracotomy pain can be reduced. Partial rib resection is applied in clinical practice in selected patient groups. However, we could not find a clinical study on this subject in the English literature. The aim of this study is to determine whether partial rib resection has an effect on the control of thoracotomy pain.
Before the thoracotomy incision, simple randomization will be performed by flipping a coin.
Routine thoracotomy incision will be performed in the control group. In the intervention group, approximately 1 cm segment of the 6th rib will be excised with a rib scissors before the thorax retractor was placed.
Pericostal suture technique will be used in both groups at thoracotomy closure. Demographic information of the cases, preoperative respiratory function parameters, body mass index, Visual Analogue Scale scores, complications and analgesic doses will be recorded in the Case Report Form regularly.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Group | No Intervention | Includes patients undergoing routine thoracotomy | |
| Intervention Group | Experimental | The group that will undergo 1 cm partial rib resection during thoracotomy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Partial rib resection | Procedure | 1 cm partial rib resection during thoracotomy opening |
|
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative visual analog scale scores | Min:1, Max:10 points, Higher scores mean worse outcome | 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| Iatrogenic rib fractures | Yes or no | During operation |
| Administered analgesic doses | Milligram | Up to 4 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| İsmail Dal, PhD | Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital | Istanbul | 34668 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18456219 | Background | Gerner P. Postthoracotomy pain management problems. Anesthesiol Clin. 2008 Jun;26(2):355-67, vii. doi: 10.1016/j.anclin.2008.01.007. | |
| 1093513 | Background | Meyers JR, Lembeck L, O'Kane H, Baue AE. Changes in functional residual capacity of the lung after operation. Arch Surg. 1975 May;110(5):576-83. doi: 10.1001/archsurg.1975.01360110122020. |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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Clinical data of intervention group and control groups will be compared
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Patients do not know which study group they are in. The researchers know which group the patients are in.
| Duration of drainage | Days | Up to 4 weeks |
| Length of hospital stay | Days | Up to 4 weeks |
| Number of participants with postoperative bronchopulmonary complications | Yes or no | Up to 4 weeks |
| 8722735 | Background | Katz J, Jackson M, Kavanagh BP, Sandler AN. Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain. 1996 Mar;12(1):50-5. doi: 10.1097/00002508-199603000-00009. |
| 12683601 | Background | Soto RG, Fu ES. Acute pain management for patients undergoing thoracotomy. Ann Thorac Surg. 2003 Apr;75(4):1349-57. doi: 10.1016/s0003-4975(02)04647-7. |
| 19954996 | Background | Wu N, Yan S, Wang X, Lv C, Wang J, Zheng Q, Feng Y, Yang Y. A prospective, single-blind randomised study on the effect of intercostal nerve protection on early post-thoracotomy pain relief. Eur J Cardiothorac Surg. 2010 Apr;37(4):840-5. doi: 10.1016/j.ejcts.2009.11.004. Epub 2009 Dec 1. |
| 30993532 | Background | El-Hag-Aly MA, Hagag MG, Allam HK. If post-thoracotomy pain is the target, Integrated Thoracotomy is the choice. Gen Thorac Cardiovasc Surg. 2019 Nov;67(11):955-961. doi: 10.1007/s11748-019-01126-2. Epub 2019 Apr 16. |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |