Bayesian Network Meta-Analysis of Postoperative Analgesic Techniques in Thoracoscopic Lung Resection Patients

Pain and Therapy, Год журнала: 2025, Номер unknown

Опубликована: Фев. 22, 2025

Postoperative analgesia in thoracoscopic lung resection is crucial, with several nerve block techniques—including thoracic epidural anesthesia (TEA), paravertebral (PVB), erector spinae plane (ESPB), intercostal (INB), and serratus anterior (SAPB)—commonly employed. However, there remains ongoing debate regarding the optimal technique. To evaluate compare effectiveness of these methods, a systematic review was conducted across multiple databases, including PubMed, Embase, Web Science, Cochrane Library, identifying relevant randomized clinical trials (RCTs). A Bayesian network meta-analysis performed to assess postoperative pain management, subgroup analyses meta-regression examine key factors influencing outcomes, such as risk bias, continuous catheter analgesia, patient-controlled (PCA). The results revealed that for 12-h resting visual analog scale (VAS) scores, surface under cumulative ranking curve (SUCRA) TEA > PVB ESPB control INB SAPB, whereas at 24 h, it shifted SAPB. For coughing VAS ranked highest, followed by PVB, ESPB, control. At TEA, INB, inconsistency test showed good consistency, minimal publication neither study quality nor local anesthetic infiltration incision site significantly impacted outcomes. Excluding studies without PCA did not change SUCRA rankings. consistently highest 24-h scores. Clustered plots indicated were most suitable techniques analgesia. emerged analgesic resection. While superior efficacy, offered fewer side effects, providing safety advantage. considered less due its excessive effects.

Язык: Английский

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COMPARISON OF THE EFFECTS OF COMBINED RHOMBOID INTERCOSTAL AND SUB-SERRATUS PLANE BLOCK VS. RHOMBOID INTERCOSTAL BLOCK ON POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING VIDEO-ASSISTED THORACOSCOPIC SURGERY FOR WEDGE RESECTION

Journal of Cardiothoracic and Vascular Anesthesia, Год журнала: 2025, Номер unknown

Опубликована: Май 1, 2025

Язык: Английский

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The 50% effective dose of hydromorphone and morphine for epidural analgesia in the hemorrhoidectomy: a double-blind, sequential dose-finding study

BMC Anesthesiology, Год журнала: 2024, Номер 24(1)

Опубликована: Янв. 30, 2024

Abstract Background Although previous studies have showed that epidural morphine can be used as a complement to local anesthetics for analgesia after postcesarean delivery under spinal anesthesia, there is little known about the analgesic dosage of and hydromorphone hemorrhoidectomy. Therefore, we conducted this study examine potency ratio well effective dose 50% patients (ED50) undergoing elective Methods 80 hemorrhoidectomy with combined anesthesia(CSEA) in department Dongguan Tungwah hospital. To assess ED50, were treated or randomly using biased coin method-determined sequential allocation procedure. Following surgery, standardized multimodal was administered all patients. A pain response score ≤ 3 (on scale 0–10) determined 24 h following CSEA. The ED50 both groups probit regression isotonic method. We also measured intensity by patient interview 10 point verbal numeric rating prospectively at 6, 12 CSEA, adverse effects noted. Results 0.350 mg (95% CI, 0.259–0.376 mg) group 1.129 0.903–1.187 group, respectively, estimated Regression analysis probit, 0.366 0.276–0.388 1.138 0.910–1.201 mg). Exploratory findings no difference between most frequent dosages occurrence nausea, vomiting pruritus. When opioids doses higher, 97.5% (39/40) satisfied their analgesia. Conclusion Effective requires 3:1 hydromorphone. Both drugs provide excellent satisfaction.

Язык: Английский

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Thoracic wall block for minimally invasive thoracic surgery: enough analgesic advantages to improve functional outcomes?

Minerva Anestesiologica, Год журнала: 2024, Номер 90(6)

Опубликована: Июнь 1, 2024

Язык: Английский

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Pro's and con's of different blocks for postoperative analgesia after video-assisted thoracic surgery

Current Opinion in Anaesthesiology, Год журнала: 2024, Номер unknown

Опубликована: Дек. 6, 2024

Purpose of review Although there are a lot studies examining the effects different blocks for postoperative analgesia after video-assisted thoracic surgery (VATS), results controversial. Recent findings Paravertebral block, serratus anterior plane block and erector spinae appear to be effective beneficial post-VATS analgesia, but probably in manners. Summary All three can suggested daily practice, choice should based on personal experience preference anesthetist. Better required objective decision.

Язык: Английский

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Efficacy of liposomal as compared to standard bupivacaine for intercostal nerve blocks in patients undergoing minimally invasive thoracic surgery: a systematic review and meta-analysis

Minimally Invasive Therapy & Allied Technologies, Год журнала: 2024, Номер unknown, С. 1 - 11

Опубликована: Дек. 24, 2024

This review aimed to provide evidence on the efficacy of liposomal bupivacaine as compared standard for intercostal nerve blocks (ICB) in patients undergoing minimally invasive thoracic surgery.

Язык: Английский

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