Review of Pain Management in Thoracic Surgery Patients, 2018

Thoracic surgical procedure results in severe pain. The pain presents a unique challenge to surgeons and pain management teams. A variety of techniques have been employed with variable success. Currently, thoracic epidural represents the "gold standard" of pain control. However, problems exist with this approach. Problems include cost, constant management/adjustment and exclusion of certain patients, hypotension, urinary retention and possible hematoma. Liposomal bupivacaine provides a long acting local anesthetic. It provides multiple potential benefits. The benefits include single application, decreased overall cost, no catheter related problems, and limited opioid use. We provide an update on thoracic surgery pain control with an emphasis on new long acting liposomal bupivacaine.