Post-operative pain management in thoracic surgery patients

Title : Post-operative pain management in thoracic surgery patients

Abstract:

Aim: Effective post-operative pain management is critical for optimizing recovery and reducing complications in thoracic surgery patients. This study aimed to enhance pain control strategies by implementing a multimodal analgesia protocol and educational interventions, in accordance with Enhanced Recovery After Surgery (ERAS) guidelines.

Methods: A retrospective analysis of current pain management practices was conducted in patients undergoing open, robotic-assisted, and video-assisted thoracic surgery (VATS) at St Bartholomew’s Hospital. Data on patient-reported pain scores, analgesic use, and post-operative recovery, including length of hospital stay (LOS) and complication rates, were collected.Based on the findings, targeted interventions were implemented to improve analgesia and raise awareness among healthcare providers and patients. These included:

• Standardized Multimodal Analgesia Protocol: Developed in accordance with the Enhanced Recovery after Surgery (ERAS) guidelines and in collaboration with the acute pain team, incorporating opioid-sparing strategies with regional anesthesia, non-opioid analgesics, and adjunct medications.
• Educational Sessions: Conducted for surgeons, anesthetists, and nursing staff to reinforce best practices in pain management.
• Clinical Reminders: Informational flyers displayed in clinical areas to prompt appropriate post-operative analgesic prescribing.
• Patient-Centered Education: Patients were encouraged to actively request pain relief when needed, fostering shared decision-making in pain management.
• Nursing-Led Interventions: Nurses were instructed to routinely assess and remind patients of available analgesic options, ensuring proactive pain control.

Results: Following implementation, post-operative outcomes showed measurable improvements. Patients reported lower pain scores, indicating better pain control. Additionally, there was a reduction in opioid consumption, leading to fewer opioid-related side effects. The incidence of post-operative complications, such as respiratory issues due to inadequate pain relief, also declined. Most notably, the average length of hospital stay (LOS) was reduced, reflecting enhanced recovery and overall patient well-being.

Conclusion: A structured, multimodal approach to post-operative pain management, incorporating standardized analgesia protocols and educational initiatives, significantly improved patient outcomes following thoracic surgery. The findings underscore the importance of continuous quality improvement strategies in perioperative care. Future efforts should focus on sustaining these improvements, further refining analgesia protocols, and expanding patient and provider education to ensure optimal pain management and recovery.

Biography:

Marten AttaAlla, M.D., pursued his medical education at Charles University, graduating among the top 10 students of his cohort. Following his graduation, he conducted research at the prestigious Mayo Clinic in Rochester, USA, where he contributed to groundbreaking work in the cardiovascular disease laboratory under the mentorship of Dr. Jordan Miller. His research focused on the role of the SIRT6 gene in aortic valve disease, utilizing genetically modified murine models to elucidate its pathophysiological mechanisms. he has presented his findings at international conferences and maintains an active research collaboration with the Mayo Clinic. He subsequently undertook a clinical fellowship in cardiothoracic surgery at St. Bartholomew’s Hospital in London, the largest cardiothoracic center in Europe. In parallel with his clinical training, he has successfully completed the MRCS Part A examination, continues to contribute to the scientific literature through ongoing research publications, and is actively involved in medical education, mentoring and teaching future physicians.