Analgesic Efficacy of Thoracoscopic Direct-View Versus Ultrasound-Guided Thoracic Paravertebral Block in Multi-Port Video-Assisted Thoracoscopic Lung Surgery: A Randomized Controlled Non-Inferiority Study DOI Creative Commons
Yao Tong, Jimin Wu, Xuhui Wu

et al.

Drug Design Development and Therapy, Journal Year: 2025, Volume and Issue: Volume 19, P. 1825 - 1838

Published: March 1, 2025

Purpose: This study compares the analgesic effects of Thoracoscopic Direct-view Thoracic Paravertebral Nerve Block (DTPVB) with those Ultrasound-guided (UTPVB), providing a clinical reference. Patients and Methods: Sixty-eight patients undergoing three-port video-assisted thoracic surgery (VATS) general anesthesia were randomly assigned to either DTPVB group (Group D, n = 34) or UTPVB U, 34). Both groups received 10 mL injection 0.75% ropivacaine at T4 T7 interspaces. Primary outcomes cumulative sufentanil equivalents from start lung manipulation 24 hours postoperatively, differences assessed against non-inferiority margin 5 μg (Δ). Secondary include postoperative pain scores, consumption, patient satisfaction, adverse effects, other related indicators. Results: The use postoperatively was 35.0 ± 6.1 in Group D 33.2 5.6 no significant difference (P 0.217). minus U) 1.8 (95% CI − 1.07, 4.65), within Postoperative complications similar between groups. However, associated lower anxiety higher satisfaction (P< 0.001). At 15 minutes post-block, plasma concentrations (P=0.024). Conclusion: DTPVB, via transmural pleural puncture, non-inferior efficacy beginning lungs operation 24h postoperatively. provides good alternative, especially for who are anxious before surgery, have difficulty cooperating UTPVB, cases where puncture fails. when using high ropivacaine, greater vigilance toxicity is required. Keywords: paravertebral block, TPVB, thoracoscopic VATS, management

Language: Английский

Postoperative recovery with continuous erector spinae plane block or video-assisted paravertebral block after minimally invasive thoracic surgery: a prospective, randomised controlled trial DOI Creative Commons
Aneurin Moorthy, Aisling Ní Eochagáin,

Eamon Dempsey

et al.

British Journal of Anaesthesia, Journal Year: 2022, Volume and Issue: 130(1), P. e137 - e147

Published: Sept. 13, 2022

Language: Английский

Citations

49
Incidence and risk factors for chronic postsurgical pain following video-assisted thoracoscopic surgery: a retrospective study DOI Creative Commons
Yingying Zhang, Rong Zhou,

Bailing Hou

et al.

BMC Surgery, Journal Year: 2022, Volume and Issue: 22(1)

Published: March 2, 2022

Video-assisted thoracoscopic surgery (VATS) has been widely used as an alternative for thoracotomy, but the reported incidence of chronic postsurgical pain (CPSP) following VATS varied widely. The purpose this study was to investigate and risk factors CPSP after VATS.We retrospectively collected preoperative demographic, anesthesiology, surgical in a cohort patients undergoing between January 2018 October 2020. Patients were interviewed via phone survey intensity, related medical treatment 3 months VATS. Univariate multivariate analysis explore independent associated with CPSP.2348 included our study. 43.99% (n = 1033 2348). Within those suffering CPSP, 14.71% 152 1033) moderate or severe pain. Only 15.23% 23 152) sought active analgesic therapies. Age < 65 years (OR 1.278, 95% CI 1.057-1.546, P 0.011), female 1.597, 1.344-1.898, 0.001), education level less than junior school 1.295, 1.090-1.538, 0.003), 2.564, 1.696-3.877, consumption rescue analgesia postoperative 1.248, 1.047-1.486, 0.013), sedative hypnotic 2.035, 1.159-3.574, history wound infection 5.949, 3.153-11.223, 0.001) development.CPSP remains challenge clinic because half may develop Trial registration Chinese Clinical Registry (ChiCTR2100045765), 2021/04/24.

Language: Английский

Citations

41
Efficacy of erector spinae plane block for minimally invasive mitral valve surgery: Results of a double-blind, prospective randomized placebo-controlled trial DOI
Danny Feike Hoogma, Raf Van den Eynde, Layth Al Tmimi

et al.

Journal of Clinical Anesthesia, Journal Year: 2023, Volume and Issue: 86, P. 111072 - 111072

Published: Feb. 17, 2023

Language: Английский

Citations

24
Regional anaesthesia truncal blocks for acute postoperative pain and recovery: a narrative review DOI
Aisling Ní Eochagáin, Seán Carolan, Donal J. Buggy

et al.

British Journal of Anaesthesia, Journal Year: 2024, Volume and Issue: 132(5), P. 1133 - 1145

Published: Jan. 19, 2024

Language: Английский

Citations

10
Continuous erector spinae plane block versus thoracic epidural analgesia in video-assisted thoracoscopic surgery: a prospective randomized open-label non-inferiority trial DOI
Renee van den Broek,

Jonne M C Postema,

J. S. H. A. Koopman

et al.

Regional Anesthesia & Pain Medicine, Journal Year: 2024, Volume and Issue: unknown, P. rapm - 105047

Published: Jan. 11, 2024

Background and objectives The evolving surgical techniques in thoracoscopic surgery necessitate the exploration of anesthesiological techniques. This study aimed to investigate whether incorporating a continuous erector spinae plane (ESP) block into multimodal analgesia regimen is non-inferior thoracic epidural (TEA) terms quality postoperative recovery for patients undergoing elective unilateral video-assisted surgery. Methods We conducted multicenter, prospective, randomized, open-label non-inferiority trial between July 2020 December 2022. Ninety were randomly assigned receive either ESP or TEA. primary outcome parameter was Quality Recovery-15 (QoR-15) score, measured before as baseline on days 0, 1, 2. Secondary parameters included pain scores, length hospital stay, morphine consumption, nausea vomiting, itching, speed mobilization, urinary catheterization. Results Analysis showed mean QoR-15 difference groups versus TEA 1 (95% CI −9 –12, p=0.79) day –1 −11 –8, p=0.81) −2 −14 –11, Conclusions Trial registration number Dutch Register (NL6433).

Language: Английский

Citations

8
Fascial plane blocks for cardiothoracic surgery: a narrative review DOI Creative Commons
Paolo Capuano, Giuseppe Sepolvere, Antonio Toscano

et al.

Journal of Anesthesia Analgesia and Critical Care, Journal Year: 2024, Volume and Issue: 4(1)

Published: March 11, 2024

Abstract In recent years, there has been a growing awareness of the limitations and risks associated with overreliance on opioids in various surgical procedures, including cardiothoracic surgery. This shift pain management toward reducing reliance opioids, together need to improve patient outcomes, alleviate suffering, gain early mobilization after surgery, reduce hospital stay, satisfaction functional recovery, led development widespread implementation enhanced recovery surgery (ERAS) protocols. this context, fascial plane blocks are emerging as part multimodal analgesic cardiac alternatives conventional neuraxial for thoracic is body evidence suggesting their effectiveness safety providing relief these procedures. review, we discuss most common block techniques used field offering comprehensive overview regional anesthesia presenting latest use chest wall specifically setting.

Language: Английский

Citations

8
Effect of S-Ketamine on Postoperative Nausea and Vomiting in Patients Undergoing Video-Assisted Thoracic Surgery: A Randomized Controlled Trial DOI Creative Commons
Yu Qi,

Meiyan Zhou,

Wenting Zheng

et al.

Drug Design Development and Therapy, Journal Year: 2024, Volume and Issue: Volume 18, P. 1189 - 1198

Published: April 1, 2024

Purpose: Postoperative nausea and vomiting (PONV) frequently occur in patients after surgery. In this study, the authors investigated whether perioperative S-ketamine infusion could decrease incidence of PONV undergoing video-assisted thoracoscopic surgery (VATS) lobectomy. Patients Methods: This prospective, randomized, double-blinded, controlled study was conducted a total 420 from September 2021 to May 2023 at Xuzhou Central Hospital China, who underwent elective VATS lobectomy under general anesthesia with tracheal intubation. The were randomly assigned either group or control group. received bolus injection 0.5 mg/kg an intraoperative continuous rate 0.25 mg/kg/h. equivalent volume saline. All equipped patient-controlled intravenous analgesia (PCIA), 0.03 mg/kg/h μg/kg/h sufentanil primary outcome PONV. Secondary outcomes included opioid consumption, hemodynamics, postoperative pain, adverse events. Results: (9.7%) significantly lower than (30.5%). Analysis usage revealed that remifentanil 40.0% compared (1414.8 μg vs 2358.2 μg), while consumption 75.2% (33.1 133.6 μg). demonstrated better maintenance hemodynamic stability. Additionally, visual analogue scale (VAS) scores on day 1 (POD-1) 3 (POD-3) Finally, no statistically significant difference other reactions observed between two groups. Conclusion: results trial indicate can effectively reduce Keywords: S-ketamine, vomiting, non-opioid analgesic,

Language: Английский

Citations

8
Perioperative esketamine combined with butorphanol versus butorphanol alone for pain management following video-assisted lobectomy: a randomized controlled trial DOI
Hongjian Wang, Zicheng Wang, Junbao Zhang

et al.

International Journal of Clinical Pharmacy, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 3, 2025

Language: Английский

Citations

1
Prognostic factors for chronic post‐surgical pain after lung and pleural surgery: a systematic review with meta‐analysis, meta‐regression and trial sequential analysis DOI Creative Commons
Pascal R.D. Clephas, Sanne E. Hoeks, Preet Mohinder Singh

et al.

Anaesthesia, Journal Year: 2023, Volume and Issue: 78(8), P. 1005 - 1019

Published: April 24, 2023

Summary Chronic post‐surgical pain is known to be a common complication of thoracic surgery and has been associated with lower quality life, increased healthcare utilisation, substantial direct indirect costs, long‐term use opioids. This systematic review meta‐analysis aimed identify summarise the evidence all prognostic factors for chronic after lung pleural surgery. Electronic databases were searched retrospective prospective observational studies as well randomised controlled trials that included patients undergoing or reported on pain. We 56 resulting in 45 identified factors, which 16 pooled meta‐analysis. Prognostic risk follows: higher postoperative intensity (day 1, 0–10 score), mean difference (95%CI) 1.29 (0.62–1.95), p < 0.001; pre‐operative pain, odds ratio 2.86 (1.94–4.21), longer duration (in minutes), 12.07 (4.99–19.16), 0.001. decreased intercostal nerve block, 0.76 (0.61–0.95) = 0.018 video‐assisted surgery, 0.54 (0.43–0.66) Trial sequential analysis was used adjust type 1 2 errors statistical confirmed adequate power these factors. In contrast other studies, we found age had no significant effect there not enough conclude sex. Meta‐regression did reveal effects any study covariates Expressed grading recommendations, assessment, development evaluations criteria, certainty high moderate block low intensity. thus actionable can addressed attempt reduce

Language: Английский

Citations

21
Peri‐operative pain management in adults: a multidisciplinary consensus statement from the Association of Anaesthetists and the British Pain Society DOI Creative Commons
Kariem El‐Boghdadly, Nicholas Levy, William Fawcett

et al.

Anaesthesia, Journal Year: 2024, Volume and Issue: 79(11), P. 1220 - 1236

Published: Sept. 25, 2024

Summary Background Nearly half of adult patients undergoing surgery experience moderate or severe postoperative pain. Inadequate pain management hampers recovery and function may be associated with adverse outcomes. This multidisciplinary consensus statement provides principles that might aid recovery, which should applied throughout the entire peri‐operative pathway by healthcare professionals, institutions patients. Methods We conducted a directed literature review followed four‐round modified Delphi process to formulate recommendations for organisations individuals. Results make period, covering pre‐admission; admission; intra‐operative; post‐anaesthetic care unit; ward; intensive preparation discharge; post‐discharge phases care. also provide generic clinicians consider pathway, including: assessing facilitate function; use multimodal analgesia, including regional anaesthesia; non‐pharmacological strategies; safe opioids; protocols training staff in caring Conclusions hope attention these their implementation, outcomes having improved.

Language: Английский

Citations

7