Comparison of Thoracoscopy-Guided Thoracic Paravertebral Block and Ultrasound-Guided Thoracic Paravertebral Block in Postoperative Analgesia of Thoracoscopic Lung Cancer Radical Surgery: A Randomized Controlled Trial

Pain and Therapy, Journal Year: 2024, Volume and Issue: 13(3), P. 577 - 588

Published: April 9, 2024

Ultrasound-guided thoracic paravertebral block (UTPB) is widely used for postoperative analgesia in surgery. However, it has many disadvantages. Thoracoscopy-guided (TTPB) a new technique (TPB). In this study, we compared the use of TTPB and UTPB pain management after thoracoscopic radical surgery lung cancer. total, 80 patients were randomly divided 1:1 into group group. The surgical time TPB, success rate first puncture, segment range, visual analog scale (VAS) scores at 2, 6, 12, 24, 48 h post operation, incidence adverse reactions between two groups. TPB was significantly shorter than (2.2 ± 0.3 vs. 5.7 1.7 min, t = − 12.411, P < 0.001). puncture sensory higher (100% 76.9%, χ2 8.309, 0.001; 6.5 1.2 5.1 1.3 levels, 5.306, 0.001, respectively). VAS during rest coughing operation 24 lower 12 (rest: 2.5 0.4 3.4 0.6, 7.325, 0.5 3.5 7.885, coughing: 0.6 4.2 0.7, 5.057, 0.8, 4.625, No significant difference observed terms Compared with UTPB, shows advantages, such as simpler more convenient surgery, time, wider segments, superior analgesic effect. can effectively reduce due to cancer https://www.chictr.org.cn , identifier ChiCTR2300072005, prospectively registered on 31/05/2023.

Language: Английский

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Immunotherapeutic hydrogel for co-delivery of STAT3 siRNA liposomes and lidocaine hydrochloride for postoperative comprehensive management of NSCLC in a single application

Asian Journal of Pharmaceutical Sciences, Journal Year: 2024, Volume and Issue: 19(3), P. 100925 - 100925

Published: May 3, 2024

Despite standard treatment for non-small cell lung cancer (NSCLC) being surgical resection, recurrence and complications, such as induction of malignant pleural effusion (MPE) significant postoperative pain, usually result in failure. In this study, an alginate-based hybrid hydrogel (SOG) is developed that can be injected into the resection surface lungs during surgery. Briefly, endoplasmic reticulum-modified liposomes (MSLs) pre-loaded with signal transducer activator transcription 3 (STAT3) small interfering RNA lidocaine hydrochloride are encapsulated SOG. Once applied, MSLs strongly downregulated STAT3 expression tumor microenvironment, resulting apoptosis cells polarization tumor-associated macrophages towards M1-like phenotype. Meanwhile, release was beneficial pain relief natural killer activation. Our data demonstrated MSL@LID@SOG not only efficiently inhibited growth but also potently improved quality life, including reduced MPE volume orthotopic NSCLC mouse models, even a single administration. shows potential comprehensive clinical management upon NSCLC, may alter paradigms other cancers.

Language: Английский

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PROSPECT methodology for developing procedure‐specific pain management recommendations: an update

Anaesthesia, Journal Year: 2023, Volume and Issue: 78(11), P. 1386 - 1392

Published: Sept. 26, 2023

Summary The procedure‐specific postoperative pain management (PROSPECT) working group develops evidence‐based recommendations. PROSPECT methodology is unique and rigorous. However, several limitations were recognised that needed to be addressed, new factors identified improved methodology. aim of this article present updated for development recommendations management, focusing on the methodological revisions we will implement. In future, included randomised clinical trials need prospectively registered a publicly accessible database study design, including primary outcome in registration, should coincide with published manuscript. Placebo‐controlled studies which analgesic intervention interest solely paracetamol, non‐steroidal anti‐inflammatory drugs, cyclo‐oxygenase‐2‐specific inhibitors or opioids not included. Studies comparing one drug particular class another same also Future projects use Cochrane Collaboration risk bias tool quality reporting results. A modified Grading Recommendations, Assessment, Development, Evaluations (GRADE) approach used grading level evidence strength Finally, addresses other implements all add rigour transparency developing

Language: Английский

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Post-thoracotomy pain syndrome in the era of minimally invasive thoracic surgery

Journal of Thoracic Disease, Journal Year: 2024, Volume and Issue: 16(5), P. 3422 - 3430

Published: May 1, 2024

Post-thoracotomy pain syndrome (PTPS) is defined as around the wound that persists for more than 2 months after surgery. Persistent not only increases use of analgesics and their side effects but also causes many social problems, such decreased activities daily living, quality life, increased medical costs. In particular, thoracic surgery associated with a higher frequency severity chronic other diseases. The basic principles postoperative treatment, limited to surgery, are multimodal analgesic methods (using combinations several drugs minimize opioid use) around-the-clock treatment (administering at fixed time in sufficient doses). Thoracic surgeons must always be aware following three points: acute severe major risk factor pain; neuropathic due intercostal nerve injury cause its presence overlooked from stage; administered quantities according dosage volume. PTPS has compared standard thoracotomy era because development analgesia widespread minimally invasive procedures thoracoscopic robot-assisted However, no consistently effective prevention or strategies have yet been established. this review, we focus on discuss role management.

Language: Английский

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Regional anesthesia for thoracic surgery: a narrative review of indications and clinical considerations

Journal of Thoracic Disease, Journal Year: 2022, Volume and Issue: 14(12), P. 5012 - 5028

Published: Nov. 11, 2022

Surgical procedures involving incisions of the chest wall regularly pose challenges for intra- and postoperative analgesia. For many decades, opioids have been widely administered to target both, acute subsequent chronic incisional pain. Opioids are potent highly addictive drugs that can provide sufficient pain relief, but simultaneously cause unwanted effects ranging from nausea, vomiting constipation respiratory depression, sedation even death. Multimodal analgesia consists administration two or more medications techniques act by different mechanisms providing Thus, multimodal aims improve relief while reducing opioid requirements opioid-related side effects. Regional anesthesia an important component this approach.For narrative review, authors summarized currently used regional performed extensive literature search summarize specific current evidence. this, related articles January 1985 March 2022 were taken PubMed, Web Science, Embase Cochrane Library databases. Terms such as "pectoral nerve blocks", "serratus plane block", "erector spinae block" belonging blocks in thoracic surgery searched combinations.Potential advantages part regiments reduced surgical stress response, improved analgesia, consumption, risk nausea vomiting, early mobilization. Potential disadvantages include possibility bleeding procedure (particularly epidural hematoma), dural puncture with headache, systemic hypotension, urine retention, allergic reactions, local anesthetic toxicity, injuries organs including pneumothorax, a relatively high failure especially continuous techniques.This review summarizes techniques, indications, clinical considerations patients undergoing surgery, evidence studies performed. However, there is need comparing new block methods standard so applications increase patient satisfaction.

Language: Английский

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The Effect of Erector Spinae Plane Block and Combined Deep and Superficial Serratus Anterior Plane Block on Acute Pain After Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Study

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2022, Volume and Issue: 36(8), P. 2991 - 2999

Published: Feb. 4, 2022

Language: Английский

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Efficacy of serratus posterior superior intercostal plane block (SPSIPB) on post-operative pain and total analgesic consumption in patients undergoing video-assisted thoracoscopic surgery (VATS): A double-blinded randomised controlled trial

Indian Journal of Anaesthesia, Journal Year: 2023, Volume and Issue: 67(12), P. 1116 - 1122

Published: Dec. 1, 2023

Serratus posterior superior intercostal plane block (SPSIPB) is a novel technique that can provide analgesia in the hemithorax, shoulder, and back of neck. This study aimed to evaluate post-operative analgesic effect SPSIPB patients undergoing video-assisted thoracoscopic surgery (VATS).

Language: Английский

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Impact of Regional Anesthesia on Subjective Quality of Recovery in Patients Undergoing Thoracic Surgery: A Systematic Review and Meta-Analysis

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2023, Volume and Issue: 37(9), P. 1744 - 1750

Published: May 5, 2023

Language: Английский

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Impact of spinal or epidural anaesthesia on perioperative outcomes in adult noncardiac surgery: a narrative review of recent evidence

British Journal of Anaesthesia, Journal Year: 2024, Volume and Issue: 133(2), P. 380 - 399

Published: May 28, 2024

Spinal and epidural anaesthesia analgesia are important anaesthetic techniques, familiar to all anaesthetists applied patients undergoing a range of surgical procedures. Although the immediate effects well-conducted neuraxial technique on nociceptive sympathetic pathways readily observable in clinical practice, impact such techniques patient-centred perioperative outcomes remains an area uncertainty active research. The aim this review is present narrative synthesis contemporary science topic from most recent 5-year period summarise foundational scholarship upon which research was based. We searched electronic databases for primary research, secondary opinion pieces, guidelines reporting relationship between procedures standardised over 2018-2023. Returned citation lists were examined seeking additional studies contextualise our results. Articles retrieved encompassing following outcome domains: patient comfort, renal, sepsis infection, postoperative cancer, cardiovascular, pulmonary mortality outcomes. Convincing evidence beneficial effect comfort after major open thoracoabdominal surgery identified. Recent benefit prevention complications Despite mechanistic plausibility supportive observational evidence, there less certain experimental support role impacting other domains. Evidence positive best established domains complications, mortality, particularly setting surgery. does not strongly significant or cardiovascular noncardiac groups.

Language: Английский

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Relative perioperative analgesic efficacy of single-shot serratus anterior plane block versus thoracic paravertebral block in breast and thoracic surgeries – A systematic review and meta-analysis of randomised controlled trials

Indian Journal of Anaesthesia, Journal Year: 2025, Volume and Issue: 69(1), P. 54 - 64

Published: Jan. 1, 2025

Various regional analgesia techniques, such as thoracic paravertebral (TPV) and serratus anterior plane (SAP) blocks, have been employed to manage postoperative pain following chest wall surgery. However, the comparative analgesic efficacy of these two approaches remains uncertain. This systematic review meta-analysis aimed assess relative blocks in surgeries, including breast procedures. The primary objective was time first rescue analgesia, secondary encompassed opioid consumption within 24 h, scores at different intervals, opioid-related adverse effects block-related complications. A search for randomised controlled trials (RCTs) conducted PubMed, EMBASE Scopus databases, covering studies from their inception September 2023. We included active treatment arms RCTs comparing modalities. Statistical analysis Review Manager Version 5.3, results were analysed reported separately surgery subgroups. Eighteen enroling 1141 patients included. Overall, no significant difference observed with a mean 0.69 h (95% confidence interval -1.83, 0.45; P = 0.24, I 2 98%) between SAP TPV block groups. demonstrated superior outcomes patients. Complications related pleural puncture haematoma injection site. evidence suggests that both generally offer comparable patients, providing slight advantage those undergoing

Language: Английский

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