Journal of Cardiothoracic and Vascular Anesthesia, Год журнала: 2024, Номер unknown
Опубликована: Дек. 1, 2024
Язык: Английский
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
Процитировано
0
Current Pain and Headache Reports, Год журнала: 2023, Номер 27(10), С. 587 - 600
Опубликована: Авг. 25, 2023
Язык: Английский
Процитировано
6
BMC Anesthesiology, Год журнала: 2023, Номер 23(1)
Опубликована: Дек. 1, 2023
Abstract Background Postoperative pain remains a significant concern following uniportal thoracoscopic surgery. The analgesic efficacy of erector spinae plane block (ESPB) and serratus anterior (SAPB) in terms postoperative opioid consumption surgery still needs further studies. Methods A randomized controlled trial was conducted, enrolling 150 patients who underwent lobectomy. were randomly allocated to three groups 1:1:1 ratio: the ESPB group (administered 20 ml 0.5% ropivacaine), SAPB standard care (control) group. primary endpoint sufentanil during first 24 h Secondary endpoints assessed area under curve (AUC) numerical rating scale (NRS) scores, occurrence moderate severe pain, time initial request, adverse events. Results No difference observed between (adjusted difference, 1.53 [95% CI, -5.15 2.08]). However, comparison control group, both intervention demonstrated decrease consumption, with adjusted differences -9.97 -13.10 -6.84] for -12.55 -15.63 -9.47] There no AUC NRS scores rest movement groups, -7.10 1.33 -15.55] condition 5.61 -13.23 2.01] condition. At 6 postoperatively, there fewer compared those -1.37% -2.29% -0.45%]. request significantly differed among (ESPB vs Control P < 0.01, = 0.015). Conclusions In undergoing lobectomy, although two are not statistically significant, demonstrate effective reduction need rescue analgesics Moreover, experienced lower incidence at postoperatively Trial registration study registered Chinese Clinical Registry (registration No: ChiCTR1900021695, Date registration: March 5th, 2019).
Язык: Английский
Процитировано
6
Current Opinion in Anaesthesiology, Год журнала: 2023, Номер unknown
Опубликована: Ноя. 10, 2023
Purpose of review Thoracic surgery is evolving, necessitating an adaptation for perioperative anesthesia and analgesia. This highlights the recent advancements in (multimodal) analgesia minimally invasive thoracic surgery. Recent findings Continuous surgical techniques have led to a reduction trauma. However, managing pain remains major challenge, impeding postoperative recovery. The traditional neuraxial technique now deemed outdated Instead, newer regional emerged, approaches undergone (re-)evaluation by experts professional societies establish guidelines practices. Assessing quality recovery, even after discharge, has become crucial factor evaluating effectiveness these strategies, aiding clinicians making informed decisions improve care. Summary In realm surgery, typically administered through systemic techniques. Nevertheless, collaboration between anesthesiologists surgeons, utilizing surgically placed nerve blocks active chest drain management, potential significantly overall patient
Язык: Английский
Процитировано
5
Cureus, Год журнала: 2024, Номер unknown
Опубликована: Дек. 9, 2024
Flail chest is a life-threatening condition characterized by multiple rib fractures that result in partially free cage. Thoracic paravertebral block (TPVB) allows visualization of the needle tip under ultrasound guidance and can be safely performed, unlike epidural anesthesia where cannot visualized. Here, we describe case flail whom TPVB was used, as it provides same level analgesia has perfect analgesic effect. A 58-year-old man with underwent emergency sternal fixation general postoperative bilateral catheter placement. The left side difficult to puncture thus required twice. After TPVB, patient returned intensive care unit intubation. On day 2, on leaked large amount fluid removed. extubated 3. right removed 5. discharged at 14 days postoperatively without complications. reported no significant pain. may useful option effects reduced circulatory depression, particularly if performed chest.
Язык: Английский
Процитировано
1
Journal of Cardiothoracic and Vascular Anesthesia, Год журнала: 2024, Номер unknown
Опубликована: Дек. 1, 2024
Язык: Английский
Процитировано
1