Comparison between thoracic epidural analgesia VS patient controlled analgesia on chronic postoperative pain after video-assisted thoracoscopic surgery: A prospective randomized controlled study

IF 5 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2024-11-27 DOI:10.1016/j.jclinane.2024.111685

Ling Jiang M.D , Chengyu Wang M.D , Jie Tong M.D , Xiaodan Han pH.D , Changhong Miao pH.D , Chao Liang pH.D

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引用次数: 0

Abstract

Study objective

To test the hypothesis that thoracic epidural anesthesia and analgesia (TEA) reduces the incidence of chronic postoperative pain (CPSP) after video-assisted thoracoscopic surgery (VATS).

Design

A single-center, single-blind, randomized controlled trial was conducted.

Setting

The study was conducted in the operating room, with follow-up assessments performed in the ward. Telephone was used to follow the long-term outcomes.

Patients

231 patients ≥18 years of age and scheduled for VATS.

Interventions

Patients were randomized into two groups, including an epidural block (EPI) group (general anesthesia with patient-controlled epidural analgesia) and a general anesthesia with patient-controlled intravenous analgesia (PCIA) group.

Measurements

The primary endpoint was the incidence of CPSP at 3 months postoperatively. CPSP data, including acute pain, neuropathic pain, depression, and side effects, were collected at 3 and 6 months postoperatively through telephone follow-up.

Main results

A total of 231 patients were analyzed, including 114 in the PCIA group and 117 in the EPI group. Sixty-six patients (56.4 %) in the PCIA group and 33 patients (28.9 %) in the EPI group experienced chronic pain at 3 months postoperatively. The odds ratio (OR) was 0.31 (95 % confidence interval [CI], 0.18 to 0.54; P < 0.0001). After adjusting for confounding factors, the adjusted OR was 0.28 (95 % CI, 0.16 to 0.50, P < 0.001). Six months postoperatively, 50 (42.7 %) and 17 (14.9 %) patients in the PCIA and EPI groups, respectively, were diagnosed with CPSP (P < 0.0001).

查看原文本刊更多论文

胸腔硬膜外镇痛与患者自控镇痛对视频辅助胸腔镜手术后慢性术后疼痛的比较：前瞻性随机对照研究

研究目的验证胸腔硬膜外麻醉和镇痛（TEA）可降低视频辅助胸腔镜手术（VATS）后慢性术后疼痛（CPSP）发生率的假设.设计进行了一项单中心、单盲、随机对照试验.设置研究在手术室进行，随访评估在病房进行。干预将患者随机分为两组，包括硬膜外阻滞（EPI）组（全身麻醉加患者控制的硬膜外镇痛）和全身麻醉加患者控制的静脉镇痛（PCIA）组。通过电话随访收集术后 3 个月和 6 个月的 CPSP 数据，包括急性疼痛、神经病理性疼痛、抑郁和副作用。PCIA 组有 66 名患者（56.4%）和 EPI 组有 33 名患者（28.9%）在术后 3 个月出现慢性疼痛。几率比（OR）为 0.31（95 % 置信区间 [CI]，0.18 至 0.54；P < 0.0001）。在对混杂因素进行调整后，调整后的 OR 为 0.28（95 % 置信区间 [CI]，0.16 至 0.50；P < 0.001）。术后六个月，PCIA 组和 EPI 组分别有 50 名（42.7%）和 17 名（14.9%）患者被诊断为 CPSP（P <0.0001）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.