Pain management after thoracotomy with dexamethasone and bupivacaine through a peripleural cather: a randomized controlled trial.
Humans
Dexamethasone
/ administration & dosage
Thoracotomy
/ adverse effects
Male
Pain, Postoperative
/ drug therapy
Female
Bupivacaine
/ administration & dosage
Middle Aged
Anesthetics, Local
/ administration & dosage
Double-Blind Method
Pain Management
/ methods
Postoperative Nausea and Vomiting
/ epidemiology
Adult
Pain Measurement
/ methods
Analgesics, Opioid
/ administration & dosage
Aged
Drug Therapy, Combination
Bupivacaine
Dexamethasone
Pain
Peripleural Catheter
Thoracotomy
Journal
BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535
Informations de publication
Date de publication:
16 Jul 2024
16 Jul 2024
Historique:
received:
06
03
2024
accepted:
08
07
2024
medline:
17
7
2024
pubmed:
17
7
2024
entrez:
16
7
2024
Statut:
epublish
Résumé
Thoracotomy procedures can result in significant pain and cause nausea/vomiting. Glucocorticoids have anti-emetic and analgesic effects due to their anti-inflammatory and nerve-blocking properties. This study investigates the additive effect of local dexamethasone with bupivacaine as sole analgesic medication through a peripleural catheter after thoracotomy. The study was conducted as a randomized control trial on 82 patients. Participants were allocated to receive either 2.5 mg/kg of bupivacaine plus 0.2 mg/kg of dexamethasone or 2.5 mg/kg of bupivacaine plus the same amount of normal saline as placebo through a 6 French peripleural catheter implemented above the parietal pleura and beneath the musculoskeletal structure of the chest wall. The primary outcome was the severity of pain 24 h after the operation in the visual analogue scale (VAS) score. Secondary outcomes were the incidence of nausea/vomiting, opioid consumption for pain control, and incidence of any adverse effects. A total of 50 participants were randomized to each group, and the baseline characteristics were similar between the groups. Median of VAS score (6 (3-8) vs. 8 (6-9), p < 0.001), postoperative opioid consumption (9 (36%) vs. 17 (68%) patients, p=0.024), and median length of hospital stay (4 (3-8) vs. 6 (3-12) days, p < 0.001) were significantly lower in the dexamethasone group. However, postoperative nausea/vomiting (p=0.26 for nausea and p=0.71 for vomiting) and surgical site infection (p = 0.55) were similar between the two groups. In thoracotomy patients, administering local dexamethasone + bupivacaine through a peripleural catheter can reduce postoperative pain, analgesic consumption, and length of hospital stay. Iranian Registry of Clinical Trials (IRCT20220309054226N1, registration date: 3/21/2022.
Identifiants
pubmed: 39014323
doi: 10.1186/s12871-024-02625-3
pii: 10.1186/s12871-024-02625-3
doi:
Substances chimiques
Dexamethasone
7S5I7G3JQL
Bupivacaine
Y8335394RO
Anesthetics, Local
0
Analgesics, Opioid
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
240Informations de copyright
© 2024. The Author(s).
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