Assessment of intercostal nerve block analgesia and local anesthetic infiltration for thoracoscopic pulmonary bullae resection: a comparative study.
Humans
Female
Male
Nerve Block
/ methods
Intercostal Nerves
Middle Aged
Pain, Postoperative
/ prevention & control
Anesthetics, Local
/ administration & dosage
Blister
Adult
Thoracoscopy
/ methods
Anesthesia, Local
/ methods
Thoracic Surgery, Video-Assisted
/ methods
Pain Measurement
Ropivacaine
/ administration & dosage
Lung Diseases
/ surgery
Aged
Analgesia
/ methods
Intercostal nerve block
Local anesthetic infiltration
Thoracoscopic pulmonary bullae resection
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
01 Oct 2024
01 Oct 2024
Historique:
received:
30
04
2024
accepted:
15
09
2024
medline:
2
10
2024
pubmed:
2
10
2024
entrez:
1
10
2024
Statut:
epublish
Résumé
The purpose of this study was to compare the analgesic effects of intercostal nerve block (ICNB) and local anesthetic infiltration (LAI) on postoperative pain and recovery following thoracoscopic resection of pulmonary bullae. A total of 160 patients undergoing thoracoscopic pulmonary bullae resection were randomly assigned to receive either ICNB (n = 80) or LAI (n = 80). An experienced anesthesiologist administered ultrasound guided ICNB at the T4 and T7 levels with 5 mL of 0.375% ropivacaine hydrochloride for the ICNB group. Instead, the LAI group received 10 mL of the same concentration of ropivacaine hydrochloride at the same concentration used for ICNB for infiltration anesthesia at the incision sites. Out of the initial cohort, 146 patients completed the study (ICNB group, n = 71; LAI group, n = 75). The collected data included preoperative clinical characteristics, visual analog scale (VAS) scores for pain at various time points post-surgery (6, 12, 24, 48, and 72 h). Additionally, the Quality of Recovery-15 (QoR-15) questionnaire was administered 24 h after surgery, and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). No significant differences were found in drainage volume, use of additional analgesics, duration of chest tube placement, or hospital stay between the two groups. However, the ICNB group had significantly lower VAS scores and QoR-15 scores 24 h postoperatively (p < 0.05), indicating better pain management and recovery. The ICNB group also reported better sleep quality, as reflected by lower PSQI scores. ICNB provides superior analgesia compared to LAI after thoracoscopic resection of pulmonary bullae, significantly improving postoperative recovery.
Identifiants
pubmed: 39354598
doi: 10.1186/s13019-024-03095-x
pii: 10.1186/s13019-024-03095-x
doi:
Substances chimiques
Anesthetics, Local
0
Ropivacaine
7IO5LYA57N
Types de publication
Journal Article
Randomized Controlled Trial
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
565Subventions
Organisme : Xuzhou Key R&D Program Project
ID : KC21212
Organisme : Xuzhou Key R&D Program Project
ID : KC21212
Organisme : Intramural Research Project of Group Military Hospital
ID : YNZD-2022001
Organisme : Intramural Research Project of Group Military Hospital
ID : YNMS-2021002
Informations de copyright
© 2024. The Author(s).
Références
Zhu CC, Chen ZX, Chen BF, Zhu HY, Rice-Narusch W, Cai XY, et al. Thoracoscopic Treatment of Giant Pulmonary Bullae. J Surg Res. 2019;243:206–12. PubMed PMID: WOS:000488045900030. English.
doi: 10.1016/j.jss.2019.05.009
pubmed: 31195349
Servais EL, Towe CW, Brown LM, Broderick SR, Block MI, Burfeind WR, et al. The Society of thoracic surgeons General thoracic surgery database: 2020 Update on outcomes and Research. Ann Thorac Surg. 2020;110(3):768–75. PubMed PMID: WOS:000565186900004. English.
doi: 10.1016/j.athoracsur.2020.06.006
pubmed: 32569670
Van Bael K, La Meir M, Vanoverbeke H. Video-assisted thoracoscopic resection of a giant Bulla in vanishing lung syndrome: case report and a short literature review. J Cardiothorac Surg. 2014;9. PubMed PMID: WOS:000331886400001. English.
Elmore B, Nguyen V, Blank R, Yount K, Lau C. Pain Management following thoracic surgery. Thorac Surg Clin. 2015;25(4):393–. PubMed PMID: WOS:000365377400003. English.
doi: 10.1016/j.thorsurg.2015.07.005
pubmed: 26515940
Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017;10:2287–98. PubMed PMID: WOS:000411594500001. English.
doi: 10.2147/JPR.S144066
pubmed: 29026331
pmcid: 5626380
Al-Kaabneh A, Qamar AA, Al-Hammouri F, Al-Majali A, Alasmar A, Al-sayedeh N et al. The effect of anaesthesia on flank incisional pain: infiltration versus intercostal nerve block, a comparative study. Pan Afr Med J. 2020;36. PubMed PMID: WOS:000589206200001. English.
Marciniak D, Kelava M, Hargrave J. Fascial plane blocks in thoracic surgery: a new era or plain painful? Curr Opin Anesthesio. 2020;33(1):1–9. PubMed PMID: WOS:000562700900001. English.
doi: 10.1097/ACO.0000000000000803
Pommerening MJ, Landau A, Hrebinko K, Luketich JD, Dhupar R. An analysis of analgesia and opioid prescribing for veterans after thoracic surgery. Sci Rep-Uk. 2020;10(1). PubMed PMID: WOS:000548564900062. English.
Joshi GP, Bonnet F, Shah R, Wilkinson RC, Camu F, Fischer B, et al. A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia. Anesth Analg. 2008;107(3):1026–40. PubMed PMID: WOS:000258702500052. English.
doi: 10.1213/01.ane.0000333274.63501.ff
pubmed: 18713924
Awad Al-Kaabneh AAQ, Firas Al-Hammouri A, Al-Majali A, Alasmar N, Al-Sayedeh F, Khori A, Qapaha, Mohammad Beidas. The effect of anaesthesia on flank incisional pain: infiltration versus intercostal nerve block, a comparative study Pan. Afr Med J. 2020;36:356.
Myles PS, Myles DB, Galagher W, Chew C, MacDonald N, Dennis A. Minimal clinically important difference for three quality of Recovery scales. Anesthesiology. 2016;125(1):39–45. PubMed PMID: WOS:000384919100017. English.
doi: 10.1097/ALN.0000000000001158
pubmed: 27159009
Zitser J, Allen IE, Falgàs N, Le MM, Neylan TC, Kramer JH et al. Pittsburgh Sleep Quality Index (PSQI) responses are modulated by total sleep time and wake after sleep onset in healthy older adults. PLoS ONE. 2022;17(6). PubMed PMID: WOS:000892027900048. English.
Jerkovic A, Mikac U, Matijaca M, Kosta V, Katic AC, Dolic K et al. Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in patients with multiple sclerosis: factor structure, reliability, correlates, and discrimination. J Clin Med. 2022;11(7). PubMed PMID: WOS:000782094900001. English.
Kayawake H, Chen FS, Date H. Surgical resection of a giant emphysematous bulla occupying the entire hemithorax. Eur J Cardio-Thorac. 2013;43(5):E136–8. PubMed PMID: WOS:000318097400006. English.
doi: 10.1093/ejcts/ezs699
Kolodii M, Azzam S, Peer M. Thoracoscopic giant lung bullaectomy: our initial experience. J Cardiothorac Surg. 2022;17(1). PubMed PMID: WOS:000769466600001. English.
Mo X, Jiang T, Wang H, Zhang Y. Erector Spinae Plane Block combined with Serratus Anterior Plane Block thoracic paravertebral block for postoperative analgesia and recovery after thoracoscopic surgery: a randomized controlled non-inferiority clinical trial. Curr Med Sci. 2023;43(3):615–22. PubMed PMID: WOS:000995307500001. English.
doi: 10.1007/s11596-023-2745-2
pubmed: 37233969
Murthy P, Jonnavithula N, Mantha S, Ch A, Devraj R, Sriramoju V. Role of Buprenorphine in prolonging the duration of postoperative analgesia in Pcnl: comparison between Bupivacaine and Bupivacaine Plus Buprenorphine Combination. J Urol. 2014;191(4):E276–E. PubMed PMID: WOS:000350277901109. English.
Sun LL, Mu J, Gao B, Pan YX, Yu L, Liu Y et al. Comparison of the efficacy of ultrasound-guided erector spinae plane block and thoracic paravertebral block combined with intercostal nerve block for pain management in video-assisted thoracoscopic surgery: a prospective, randomized, controlled clinical trial. Bmc Anesthesiol. 2022;22(1). PubMed PMID: WOS:000852385000001. English.