• Mohammed Ahmed El-Hag-Aly and Medhat Reda Nashy.
• Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt elhagaly_cts@yahoo.com.
• Interact Cardiovasc Thorac Surg. 2015 Nov 1; 21 (5): 630-5.

ObjectivesThoracic surgeons being doctors, spend much effort not only to manage pathologies but also to make their procedures painless. Many surgical manoeuvres have been evolved to reduce post-thoracotomy pain with its associated morbidities. This trial aimed to study the impact of double edge closure technique on post-thoracotomy pain.MethodsThis was a prospective pre-muted block randomized study of 120 patients who had posterolateral thoracotomy. They were equally divided into two groups, the first in which double edge closure technique was used (DE group), and the other group in which the usual pericostal sutures were used (PC group). Outcomes assessed were operative time, time to ambulation, doses of analgesics injected in the epidural catheter, postoperative complications, chest tube drainage, hospital stay and pain score by the numeric rating scale from 0 to 10 and use of analgesics during the first postoperative year.ResultsBoth groups had similar demographics, types of procedures, operative time and incisions length. Patients in DE group had significantly lower time to ambulation from 14.47 to 12.85 h, epidural doses from 3.65 to 1.87 and postoperative pain score throughout the first week. At 2 weeks, 1 and 3 months, there was significant reduction in pain and analgesics use in the DE group. At 6 months, analgesic use was not significantly different between both groups, but the pain score was significantly lower in the DE group (0.33 ± 0.51) than that in the PC group (0.63 ± 0.74). After 9 months, no significant difference was present between both groups with regard to pain score or the use of analgesics.ConclusionsDouble edge technique for thoracotomy closure is easy, rapid, safe and effective in decreasing post-thoracotomy pain with subsequent earlier ambulation and lesser use of analgesics.© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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