Author(s)

Borja Mugabure, María Eizaguirre, Silvia González, José Miguel Izquierdo, Borja Aguinagalde, Javier Martín, Pedro Martínez

Department of Anaesthesiology, Critical Care and Pain Medicine, Donostia University Hospital, San Sebastián, Spain.
Department of Maxillo-Facial Surgery, Donostia University Hospital, San Sebastián, Spain..
Department of Thoracic Surgery, Donostia University Hospital, San Sebastián, Spain.

The hemiclamshell incision is a valid but infrequent surgical alternative for the resection of tumors from mediastinum. This point makes this approach impossible to be studied under a randomized controlled trial. The triple association of thoracotomy, sternotomy and cervicothomy makes the hemiclamshell approach a high intensity postoperative pain surgery. However, there is no published data on this topic, and the reviewed articles only mention the analgesic regimens as a secondary point. Indeed, no author defines the best epidural drugs mixture for the patients. Multimodal analgesic regimen based on regional anesthesia should be used. Based on the recent advances on spinal opioids, morphine could be a good choice as epidural coadjutant to local anesthetics for hemiclamshell incision.

Hemiclamshell; Epidural Morphine; Postoperative Pain; Multimodal Analgesia

B. Mugabure, M. Eizaguirre, S. González, J. Izquierdo, B. Aguinagalde, J. Martín and P. Martínez, "Thoracic Epidural Morphine for Postoperative Analgesia after Hemiclamshell Incision in Castleman Disease," Open Journal of Anesthesiology, Vol. 3 No. 3, 2013, pp. 156-160. doi: 10.4236/ojanes.2013.33036.