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Gharagozloo. Mini-invasive Surg 2020;4:8 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.62

Review Open Access

Pain management following robotic thoracic surgery

Farid Gharagozloo

Center for Advanced Thoracic Surgery, Global Robotics Institute, Advent Health Celebration, University of Central Florida,
Celebration, FL 34786, USA.

Correspondence to: Dr. Farid Gharagozloo, Center for Advanced Thoracic Surgery, Global Robotics Institute, Advent Health
Celebration, University of Central Florida, 400 Celebration Place, Celebration, FL 34786, USA. E-mail: gharagozloof@aol.com

How to cite this article: Gharagozloo F. Pain management following robotic thoracic surgery. Mini-invasive Surg 2020;4:8.
http://dx.doi.org/10.20517/2574-1225.2019.62
Received: 19 Dec 2019 First Decision: 13 Jan 2020 Revised: 14 Jan 2020 Accepted: 17 Jan 2020 Published: 12 Feb 2020

Science Editor: Noriyoshi Sawabata Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract
For robotic thoracic surgical patients, minimizing pulmonary complications is the key to decreasing morbidity. Once
the pain is controlled, the morbidity associated with thoracic surgery is decreased. Consequently, control of pain
is the core requirement in robotic thoracic surgical patients. Appropriate pain control depends on a multifaceted
program that is based on an understanding of the pathophysiology of pain. A multifaceted pain control program
after robotic surgery needs to address local and systemic pain pathways. This review outlines such a multifaceted
program with the use of subpleural catheters for prolonged ambulatory infusion of local anesthetic for 10 days,
nonsteroidal anti-inflammatory agents, and measured use of narcotic analgesics.

Keywords: Robotic surgery, pain management, analgesia, subpleural catheters, on-Q

INTRODUCTION
Although it is hypothesized that robotic surgery is associated with lower pain-related morbidity, it is
important to address pain in the patient undergoing robotic surgery as diligently as a patient undergoing
any other thoracic surgical procedure. Unlike the abdomen, even the most minimally invasive procedures
on the chest can be painful. In addition, the nature and severity of the thoracic pain experience for each
individual patient is highly subjective and complex. Therefore, regardless of the number and type of
incisions or ports, acute and chronic pain associated with robotic thoracic surgical procedures should be
recognized and treated aggressively.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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