ABSTRACT

Pain from a thoracotomy incision is more intense than from other sites owing to continuous chest wall movement with ventilation. The area is extensively innervated and a thoracotomy involves resection or trauma to ribs, periosteum, muscles, intercostal nerves, pericardium, pleura, lungs and the diaphragm. High-quality analgesia is required to: • allow the patient to take deep inspiratory breaths and clear pulmonary

secretions • limit the stress response • allow early mobilisation.