Postoperative recovery with continuous erector spinae plane block or video-assisted paravertebral block after minimally invasive thoracic surgery: a prospective, randomised controlled trial

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

Published: Sept. 13, 2022

Language: Английский

---

Chronic Postsurgical Pain Raises Risk of Dementia

European Journal of Pain, Journal Year: 2025, Volume and Issue: 29(4)

Published: Feb. 21, 2025

ABSTRACT Purpose This study aimed to investigate the association between chronic postsurgical pain (CPSP) and risk of dementia, addressing a significant gap in existing literature highlighting potential implications for clinical practice public health. Patients Methods Utilising data from Taiwan's National Health Insurance Research Database, propensity score‐matched cohort was conducted involving 142,682 patients who underwent major surgery 2004 2018. CPSP defined as prolonged analgesic use post‐surgery, dementia diagnosis tracked until December 31, 2022. Multivariable Cox regression models were employed calculate adjusted hazard ratios (aHRs) versus non‐CPSP groups. Results Before score matching, ( n = 37,438) exhibited higher with aHRs 1.35 (95% CI: 1.30–1.40). After aHR remained elevated at 1.31 1.26–1.37), indicating risk. Subgroup analysis confirmed this across various demographic factors, sensitivity reinforcing robustness findings. Conclusion establishes an independent predictor risk, importance postoperative management mitigating long‐term cognitive outcomes. Approximately 30% post‐CPSP presents opportunity reduction through effective strategies, emphasising need targeted interventions address critical healthcare issue. Significance provides compelling evidence that significantly increases previously underexplored connection decline. By establishing our findings underscore strategies surgical patients, particularly mitigate heightened improve

Language: Английский

---

Prevalence and Predictors of Chronic Postsurgical Pain After Video-Assisted Thoracoscopic Surgery: A Systematic Review and Meta-analysis

Pain and Therapy, Journal Year: 2022, Volume and Issue: 12(1), P. 117 - 139

Published: Oct. 13, 2022

Determining the prevalence of chronic postsurgical pain (CPSP) after video-assisted thoracoscopic surgery (VATS) and identifying CPSP predictors should improve prognosis patients undergoing VATS. Although several studies have investigated VATS, there were significant dissimilarities in findings due to confounding predictors.PubMed, Cochrane, MEDLINE, Web Science, Chinese Biomedical Literature, China National Knowledge Infrastructure databases comprehensively searched using Medical Subject Headings terms "pain, postoperative," "thoracic surgery, video-assisted," all related free from inception until March 27, 2022. The Stata metaprop package was used analyze incidence following Furthermore, pooled odds ratios (OR) or standardized mean differences (SMD) their corresponding 95% confidence intervals (95% CI) calculated, qualitative analyses performed for that could not be assessed quantitatively evaluate effects included risk factors on occurrence CPSP. Unadjusted utilized consider impact non-significant estimates if original study did report them.Of 4302 studies, 183 considered eligible, 17 finally this study. overall VATS 35.3% CI 27.1-43.5%). synthesis results revealed female sex, age, acute postoperative definite number ports, operation time, duration drainage, insufficient analgesia also predictors. Consistent, quantitative showed aforementioned closely Only by analysis, chemotherapy an educational level less than junior school Other displayed no evidence unclear association with VATS.This preliminarily determined based existing literature. Female identified as other potential analyzed. However, a result inclusion retrospective inevitable limitations systematic review meta-analysis, still need verified large-scale prospective clinical studies.CRD42022323179.

Language: Английский

---

A prospective study of chronic postsurgical pain in elderly patients: incidence, characteristics and risk factors

BMC Geriatrics, Journal Year: 2023, Volume and Issue: 23(1)

Published: May 12, 2023

Abstract Background Due to the continued growth of surgical procedures in older adults and significant impact chronic postsurgical pain (CPSP), it is crucial improve our understanding occurrence CPSP as well appropriate prevention treatment. We therefore conducted this study determine incidence, characteristics risk factors elderly patients at both 3 6 months after surgery. Methods Elderly (aged ≥ 60 years) undergoing elective surgery institution between April 2018 March 2020 were prospectively enrolled study. Data on demographics, preoperative psychological well-being, intraoperative anesthesia management, acute postoperative intensity collected. At surgery, received telephone interview completed questionnaires regarding characteristics, analgesic consumption, interference with activities daily living (ADL). Results A total 1065 followed up for included final analysis. operation, incidence was 35.6% [95% confidence interval (95% CI) 32.7 − 38.8%] 21.5% CI 19.0% 23.9%), respectively. cause negative impacts patient’s ADL most particularly mood. Neuropathic features found 45.1% months. months, 31.0% those reported that had neuropathic features. Preoperative anxiety [3 months: Odds ratio (OR) 2.244, 95% 1.693 2.973; OR 2.397, 1.745 3.294], depression (3 1.709, 1.292 2.261; 1.565, 1.136–2.156), orthopedic 1.927, 1.112 3.341; 2.484, 1.220 5.061), higher severity movement within 24 h 1.317, 1.191 1.457; 1.177 1.475) associated a independently Conclusions common complication patients. depression, greater are an increased CPSP. It should be kept mind developing interventions reduce optimizing management will effective reducing development population.

Language: Английский

---

Evidence summary on pain management in thoracoscopic lung cancer surgery

Asia-Pacific Journal of Oncology Nursing, Journal Year: 2025, Volume and Issue: unknown, P. 100693 - 100693

Published: March 1, 2025

Language: Английский

---

Comparison of the analgesic effects of liposomal bupivacaine in ultrasound-guided erector spinae plane block and surgeon-administered intercostal nerve block following video-assisted thoracoscopic lung resection: protocol for a randomized controlled trial

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 12

Published: March 31, 2025

Background The analgesic efficacy of liposomal bupivacaine (LB) for ultrasound-guided erector spinae plane block (ESPB) and thoracoscopic intercostal nerve (ICNB) in thoracic surgery remains uncertain. This study aims to evaluate the anesthesiologist-performed ESPB using LB versus surgeon-administrated ICNB with patients undergoing video-assisted (VATS) lung resection. Methods single-center, prospective, randomized, double-blinded trial will include 120 adult scheduled VATS Patients be randomly assigned 1:1 group or group. Each patient receive either an at end surgery, along patients-controlled intravenous analgesia (PCIA) as part a postoperative multimodal analgesia. primary outcome is average numeric rating scale (NRS) pain scores rest over 72 h postoperatively (average three 24-h time points: 24, 48, h). Secondary outcomes NRS during activity postoperatively, Quality Recovery 15 first press on PCIA device, total opioid consumption within initiate independent bedside mobilization, length hospital stay, incidence chronic (defined score ≥ 1) 3 months post-surgery. Analyses performed modified intention-to-treat population. Discussion We hypothesize that result lower compared findings this aim provide evidence optimize regimens Clinical registration http://www.chictr.org.cn , identifier ChiCTR2400092927.

Language: Английский

---

Impact of video-assisted thoracic surgery versus open thoracotomy on postoperative wound infections in lung cancer patients: a systematic review and meta-analysis

BMC Pulmonary Medicine, Journal Year: 2025, Volume and Issue: 25(1)

Published: April 7, 2025

Lung cancer surgery has evolved significantly, with minimally invasive video-assisted thoracic (VATS) procedures being compared traditional open thoracotomies. The incidence of postoperative wound infections is a significant factor influencing the choice surgical technique. This systematic review and meta-analysis aim to evaluate impact thoracoscopic versus thoracotomy on in lung patients. Following PRISMA guidelines, comprehensive search across PubMed, Embase, Web Science, Cochrane Library was conducted September 19, 2023, without time or language restrictions. Peer-reviewed randomized controlled trials, cohort studies, case-control studies reporting were included. Studies not differentiating between techniques focusing irrelevant populations excluded. Data extraction quality assessment independently carried out by two reviewers, using fixed-effect model for due absence heterogeneity (I2 = 0.0%, P 0.766). A total six articles indicated low risk bias most domains. pooled results showed that had twofold increased (OR 2.00, 95% CI: 1.04-3.85) VATS procedures. Publication funnel plots Egger's test revealed no biases (P > 0.05). findings suggest associated lower thoracotomy, which implications decision-making treatment. Not applicable.

Language: Английский

---

Identifying risk factors for chronic postsurgical pain and preventive measures: a comprehensive update

Expert Review of Neurotherapeutics, Journal Year: 2023, Volume and Issue: 23(12), P. 1297 - 1310

Published: Nov. 24, 2023

Introduction Chronic postsurgical pain (CPSP) is a prevalent condition that can diminish health-related quality of life, cause functional deficits, and lead to patient distress. Rates CPSP are higher for certain types surgeries than others (thoracic, breast, or lower extremity amputations) but occur after even uncomplicated minimally invasive procedures. has multiple mechanisms, always starts as acute pain, which involves inflammatory processes may encompass direct indirect neural injury. Risk factors largely known many, such female sex, younger age, type surgery, not modifiable. The best strategy against quickly effectively treat postoperative using multimodal analgesic regimen safe, effective, spares opioids.

Language: Английский

---

Dexmedetomidine attenuates inflammatory response and chronic pain following video-assisted thoracoscopic surgery for lung cancer

Surgery, Journal Year: 2024, Volume and Issue: 176(4), P. 1263 - 1272

Published: July 12, 2024

Language: Английский

---

Integrating mechanistic-based and classification-based concepts into perioperative pain management: an educational guide for acute pain physicians

Regional Anesthesia & Pain Medicine, Journal Year: 2023, Volume and Issue: 49(8), P. 581 - 601

Published: Jan. 27, 2023

Chronic pain begins with acute pain. Physicians tend to classify by duration (acute vs chronic) and mechanism (nociceptive, neuropathic nociplastic). Although this taxonomy may facilitate diagnosis documentation, such categories are some degree arbitrary constructs, significant overlap in terms of mechanisms treatments. In clinical practice, there myriad different definitions for chronic a substantial portion involves mixed phenotypes. Classification based on acuity informs management at all levels constitutes critical part guidelines treatment care. Yet specialty care is often siloed, advances understanding lagging years behind areas which these developments should be the forefront practice. For example, perioperative management, enhanced recovery protocols not standardized drive without consideration mechanisms, many cases incongruent personalized medicine mechanism-based treatment. educational document, we discuss classification as it pertains commonly performed surgical procedures. Our goal provide reference physician decision-making (both therapy) period.

Language: Английский

---