Clinical Analysis of Different Anesthesia and Analgesia Methods for Patients Undergoing Uniportal Video-assisted Lung Surgery

IF 3.2 4区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical therapeutics Pub Date : 2024-07-01 DOI:10.1016/j.clinthera.2024.06.009

Xuan Gao MD , Shuwei Wang MD , Yi Li MD , Di Zhou MD , Xuemei Peng MM

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Abstract

Purpose

The purpose of this study was to compare 3 intraoperative modalities to determine the best and most convenient one for pain control for uniportal lung surgery. This study compared general anesthesia with serratus plane block, general anesthesia with epidural, and general anesthesia alone to examine postoperative pain scores in patients.

Methods

Eighty patients were enrolled and statistically analyzed. Three interventions were studied: general anesthesia with serratus plane block (group S), general anesthesia with thoracic epidural (group E), and general anesthesia only (group G). Outcome measures compared among the 3 groups included demographic characteristics; surgical types; anesthesia and operative time; postoperative pain scores; vital signs; morphine consumption at 0, 2, and 6 hours and day 1 and day 2 after surgery; incidence of opioid-related adverse events and chronic pain; hospital length of stay (LOS); and overall expenses. The numerical rating scale was used to assess the degree of pain on the first and second postoperative days. Postoperative morphine consumption, incidence of opioid-related side effects, hospital LOS, and overall hospital expenses were documented, as well as incidence of chronic postoperative pain.

Findings

There was no difference in the incidence of opioid-related adverse events and chronic pain, hospital LOS, and overall expenses among the 3 groups. After investigating factors that may influence hospital LOS and overall expenses, the multivariable analysis indicated that only longer operative time was associated with longer hospital stay and more hospital expenses.

Implications

This prospective study found that general anesthesia alone offers an easy and efficient approach resulting in similar postoperative pain scores and morphine consumption compared with nerve block and epidural. Longer operative time was associated with longer hospital stay and more hospital expenses. ClinicalTrials.gov identifier: NCT03839160. (Clin Ther. 2024;XX:XXX–XXX) © 2024 Elsevier HS Journals, Inc.

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单孔视频辅助肺部手术患者不同麻醉和镇痛方法的临床分析

目的：本研究的目的是比较三种术中方式，以确定单孔肺部手术疼痛控制的最佳和最方便的方式。本研究比较了全身麻醉与锯齿面阻滞、全身麻醉与硬膜外麻醉以及单纯全身麻醉，以检查患者的术后疼痛评分：方法：共招募了 80 名患者并进行了统计分析。研究了三种干预方法：带锯齿面阻滞的全身麻醉（S 组）、带胸硬膜外的全身麻醉（E 组）和单纯全身麻醉（G 组）。三组间比较的结果指标包括人口统计学特征；手术类型；麻醉和手术时间；术后疼痛评分；生命体征；术后 0、2、6 小时以及术后第 1 天和第 2 天的吗啡消耗量；阿片类药物相关不良事件和慢性疼痛的发生率；住院时间（LOS）；以及总费用。术后第 1 天和第 2 天的疼痛程度采用数字评分法进行评估。记录了术后吗啡消耗量、阿片类药物相关副作用发生率、住院时间、住院总费用以及术后慢性疼痛发生率：3组患者的阿片类药物相关不良反应和慢性疼痛发生率、住院时间和总费用均无差异。在对可能影响住院时间和总费用的因素进行调查后，多变量分析表明，只有手术时间越长，住院时间越长，住院费用越高：这项前瞻性研究发现，与神经阻滞和硬膜外麻醉相比，单纯全身麻醉是一种简便有效的方法，术后疼痛评分和吗啡消耗量相似。手术时间越长，住院时间越长，住院费用越高：NCT03839160。(Clin Ther. 2024;XX:XXX-XXX) © 2024 Elsevier HS Journals, Inc.

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来源期刊

Clinical therapeutics 医学-药学

CiteScore

6.00

自引率

3.10%

发文量

154

审稿时长

9 weeks

期刊介绍： Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Editors. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases.