Thoracic pain

image of Thoracic pain
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Thoracotomy is associated with severe acute postoperative pain. Acute pain control is important to prevent complications, and to help provide effective pre-emptive analgesia. This chapter discusses appropriate general and regional anaesthesia for dealing with thoracic pain in the veterinary patient. Pneumothorax; Pleural effusion; Thoracic trauma.

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Image of 7.1
7.1 Intercostal thoracotomy wound. (a)The wound soaker catheter has been placed along the length of the wound, just dorsal to the circumcostal sutures. A minimal profile thoracostomy drain (white) has also been placed. (b)The latissimus dorsi muscle is apposed laterally to the wound soaker catheter. The wound has been completely closed. Note the in-line bacterial filter attached to the open end of the catheter followed by a needle-free valve.
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7.2 Intercostal nerve blocks performed prior to port placement in a dog with recurrent chylothorax. Note the needle caudal to the rib and in a dorsal location. Pen-marked numbers indicate respective ribs.
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7.3 Placement of a minimal profile thoracostomy drain during an intercostal thoracotomy using a modified Seldinger wire technique. The catheter is tunnelled subcutaneously and introduced into the thoracic cavity over a stylet, away from the surgical incision. The J-wire is threaded through the catheter and advanced cranioventrally. The catheter is removed over the guide wire and the minimal profile drain advanced into the thoracic cavity over the guide wire. The guide wire is then removed and the thoracostomy tube is secured in place.
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