Reducing post-thoracotomy wound pain by limited mobilisation of the intercostal muscle neu-rovascular bundle prior to wound retraction

摘要

The mechanisms for post-thoracotomy wound pain relate to damage of intercostal nerve bundle through instrumentation, traction and compression. Mobilisation and creating a pedicle intercostal muscle flap for bronchial stump augmentation is well described and from that work there have been several studies noting a reduction of post-thoracotomy pain in such patients. Having performed a standard incision and breached the pleural cavity, a short segment of the intercostal muscle neurovascular bundle from the lower-border of rib above the intercostal space breached is dissected to the bone and mobilised downwards facilitated by placing upper blade of retractor to retract scapula (Fig. 1).