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OBJECTIVE: Postoperative care of thoracic surgical patients is a very important part of patient recovery and can be very challenging. Pain management is of paramount importance post operatively as it is essential for patients to comply for chest physiotherapy and ambulation and they will be unable to do so if they have severe pain. There are various ways by which pain is managed. They include epidural catheters preoperatively, paravertebral methods pre or intraoperatively or intravenous patient controlled analgesia
METHODS: Method: we present our experience of use of opiate transdermal patch in all patients who underwent major lung resection,mediastinal mass, decortications, pleurectomy by vats / robotics. From 2012 JAN -2014OCT . 485 approximately underwent major VATS/ ROBOTIC surgeries. 166 pts had the use of opiate transdermal patch , early post operatively .Patients who were admitted in icu were not included in this study
RESULTS: All the patients were out of the bed on post op day 2 . were ambulated , were able to do good physiotherapy. Majority of the patients were discharged on day 3 and 4. Maximum use of patch continued for 2 week. Majority gave up after a week. 12 patients had complications associated with opiate trans dermal patch. On PAIN SCALE 1-10. Majority had pain between 2-3 on postop day 2.
CONCLUSIONS: use of opiate transdermal patch has definitely decreased intra venous use of analgesia. Early recovery, early ambulation, better physiotherapy, availability at the patients bed side , early discharge and greater patient satisfaction