In addition to pneumothorax, complications from thoracotomy include air leaks, infection, bleeding and respiratory failure.
[9] Postoperative pain is universal and intense, generally requiring the use of opioid analgesics for moderation, as well as interfering with the recovery of respiratory function.
A recent Cochrane review concluded that there is moderate-quality evidence that regional anaesthesia may reduce the risk of developing persistent postoperative pain three to 18 months after thoracotomy.
[16] Thoracic epidural analgesia or paravertebral blockade have shown to be the most effective methods for post-thoracotomy pain control.
However, contraindications to neuraxial anesthesia include hypovolemia, shock, increase in ICP, coagulopathy or thrombocytopenia, sepsis, or infection at puncture site.