TY - JOUR AU - Piccioni, Federico AU - Segat, Matteo AU - Falini, Stefano AU - Umari, Marzia AU - Putina, Olga AU - Cavaliere, Lucio AU - Ragazzi, Riccardo AU - Massullo, Domenico AU - Taurchini, Marco AU - Del Naja, Carlo AU - Droghetti, Andrea PY - 2018 TI - Enhanced recovery pathways in thoracic surgery from Italian VATS Group: peri-operative analgesia protocols JF - Journal of Thoracic Disease; Vol 10, Supplement 4 (March 09, 2018): Journal of Thoracic Disease (Enhanced Recovery Pathways in Thoracic Surgery from Italian VATS Group) Y2 - 2018 KW - N2 - Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the rst-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors’ experiences on perioperative multimodal analgesia principles for implementing an ERAS program after VATS lobectomy. UR - https://jtd.amegroups.org/article/view/18254