Comparisons in analgesic effects between ultrasound-guided erector spinae plane block and surgical intercostal nerve block after video-assisted thoracoscopic surgery: A randomized controlled trial.
J Clin Anesth
; 95: 111448, 2024 08.
Article
em En
| MEDLINE
| ID: mdl-38489966
ABSTRACT
STUDY OBJECTIVE:
This study aimed to compare the analgesic effects of anesthesiologist-administrated erector spinae plane block (ESPB) and surgeon-administrated intercostal nerve block (ICNB) following video-assisted thoracoscopic surgery (VATS).DESIGN:
Randomized, controlled, double-blinded study.SETTING:
Operating room, postoperative recovery room and ward in two centers. PATIENTS One hundred patients, ASA I-III and scheduled for elective VATS.INTERVENTIONS:
The anesthesiologist-administrated ESPB under ultrasound guidance or surgeon-administrated ICNB under video-assisted thoracoscopy was randomly provided during VATS. Regular oral non-opioid analgesic combined with intravenous rescue morphine were prescribed for multimodal analgesia after surgery. MEASUREMENTS The primary outcomes were the pain score and morphine consumption during 48 h after surgery. Postoperative pain intensity were assessed using the 10-cm visual analogue scale at 1 h, 24 h, and 48 h after surgery. Morphine consumption at these time points was compared between the two study groups. Furthermore, oral weak opioid rescue analgesic was also provided at 24 h after surgery. Postoperative quality of recovery at 24 h was also assessed using the QoR-15 questionnaire, along with duration of chest tube drainage and hospital stay were compared as secondary outcomes. MAINRESULTS:
Patients in the two study groups had comparable baseline characteristics, and surgical types were also similar. Postoperative VAS changes at 1 h, 24 h, and 48 h after surgery were also comparable between the two study groups. Both groups had low median scores (<4.0) at all time points (all p > 0.05). Patients in the ESPB group required statistically non-significant higher 48-h morphine consumption [3 (0-6) vs. 0 (0-6) mg in the ESPB group and ICNB group respectively; p = 0.135] and lower numbers of oral rescue analgesic (0.4 ± 1.2 vs. 1.0 ± 1.8 in the ESPB group and ICNB group respectively; p = 0.059). Additionally, patients in the two study groups had similar QoR15 scores and lengths of hospital stay.CONCLUSIONS:
Both anesthesiologist-administered ultrasound-guided ESPB and surgeon-administered VATS ICNB were effective analgesic techniques for patients undergoing VATS for tumor resection.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Dor Pós-Operatória
/
Medição da Dor
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Ultrassonografia de Intervenção
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Cirurgia Torácica Vídeoassistida
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Analgésicos Opioides
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Nervos Intercostais
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Morfina
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Bloqueio Nervoso
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article