Anesthesia and pain Mangment in thorasic surgery

The practice of thoracic anesthesia requires detailed knowledge of respiratory physiology, pharmacology,anatomy, and related surgical techniques for a patient population that frequently has major comorbidities.Anaesthesia for thoracic surgery involves a diversity of skills and expertise, including clinical judgement, preoperativeassessment, airway management, intra-operative physiology and pharmacology, and the challengesof prevention and therapy of post-operative pain. It is a growth area in anaesthetic research and practice, andis one of the most challenging types of clinical anaesthetic practice.Thoracic surgery is considered one of the most painful surgical procedures performed. Pain is mediated viaseveral mechanisms and is affected by the surgical approach as well as patient factors. Pain after thoracicsurgery can be debilitating and lead to poor outcomes, such as respiratory complications, longer hospitalstays, poor quality of life, and chronic post-thoracotomy pain syndrome. A multimodal approach topostoperative pain that combines systemic and regional anesthesia has been shown to be the mosteffective in optimizing analgesia in these patients.The incidence of long-term post-thoracotomy pain is reported to be up to ۶۷%. A relationship between theseverity of acute postoperative pain and the development of chronic post-thoracotomy pain has beensuggested.