Journal of Pain Research最新文献

{"title":"Comparison of Surgical Anesthesia Onset Between Dural-Puncture Epidural and Standard Epidural Techniques for Emergency Cesarean Section: Protocol for a Randomized Controlled Trial.","authors":"Shuangqiong Zhou, Xiuhong Cao, Yao Zhou, Zhendong Xu","doi":"10.2147/JPR.S514780","DOIUrl":"10.2147/JPR.S514780","url":null,"abstract":"<p><strong>Purpose: </strong>The dural-puncture epidural (DPE) and standard epidural (EP) techniques are well-established methods for neuraxial analgesia during labor. However, there is limited knowledge regarding the conversion of DPE-induced labor analgesia to surgical anesthesia during cesarean sections, particularly regarding efficacy and timing. This study will compare the surgical anesthesia onset time between DPE and EP in parturients undergoing emergency cesarean delivery after conversion from labor analgesia.</p><p><strong>Patients and methods: </strong>This double-blind, randomized clinical study will include 124 parturients. Parturients aged ≥18 years with singleton pregnancies who request labor analgesia will be randomly assigned to receive either DPE or EP anesthesia in the labor and delivery rooms. Participants will be excluded if they have contraindications to neuraxial anesthesia, back surgery or scoliosis history, significant fetal anomalies, or a known allergy to any of the study medications. Epidural labor analgesia will be maintained using a low concentration of ropivacaine in combination with sufentanil, delivered through the epidural catheter. During delivery, an emergency intrapartum cesarean section following labor analgesia may be necessary among these parturients. Parturients requiring intrapartum cesarean delivery following labor analgesia will be eligible. Epidural extension anesthesia will be administered in the operating room. The primary outcome measure will be the time from chloroprocaine administration to the achievement of a surgical level of anesthesia, defined as a T6 sensory block. Secondary outcomes will include epidural anesthesia quality, incidence of conversion to cesarean section between the two techniques, and maternal and neonatal outcomes.</p><p><strong>Conclusion: </strong>This study will estimate the onset time to achieve surgical anesthesia during epidural extension using a DPE compared to an EP technique. The results may provide a deeper understanding of the advantages of the DPE technique in labor analgesia, as well as determine the onset time and reliability of anesthesia block during conversion from labor analgesia to cesarean delivery.</p><p><strong>Trial registration: </strong>ChiCTR2400089237. Registered September 4, 2024.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2509-2519"},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Chronic Pain Management: Integrating Neuromodulation with Advanced Technologies to Tackle Cognitive Dysfunction - A Narrative Review.","authors":"Maja Green, Amie Hayley, Jenny M Gunnersen, Vida Nazemian, Adam Cabble, Sandra Thompson, Krishnan Chakravarthy","doi":"10.2147/JPR.S514285","DOIUrl":"10.2147/JPR.S514285","url":null,"abstract":"<p><p>Chronic pain is a complex and multidimensional condition that disrupts both physical function and cognitive processing, creating a bidirectional cycle that amplifies symptom burden and complicates clinical management. Cognitive dysfunction, characterized by deficits in memory, attention, and executive function, further impairs treatment adherence and functional recovery. Conventional pharmacologic therapies frequently fail to address this dual burden and are associated with adverse effects, including dependence and cognitive impairment. Neuromodulation has emerged as a promising nonpharmacologic alternative, capable of modulating neuroplastic, neuroinflammatory, and neurotransmitter pathways implicated in both pain and cognitive decline. This narrative review examines the mechanisms and clinical applications of spinal cord stimulation (SCS), transcutaneous electrical nerve stimulation (TENS), and neuromuscular electrical stimulation (NMES), and evaluates emerging innovations such as EcoAI™, an artificial intelligence-driven, non-invasive neuromodulation platform. By integrating physiological and behavioral biomarkers with real-time adaptive therapy, EcoAI and similar technologies represent a shift toward personalized, precision-based interventions. Additional advances in remote patient monitoring (RPM) and closed-loop feedback systems further enhance therapeutic responsiveness and continuity of care. Collectively, these approaches offer a scalable, patient-centered framework for managing chronic pain and its cognitive comorbidities. Future priorities include the development of validated biomarkers, rigorous clinical evaluation of AI-integrated systems, and equitable implementation strategies to ensure broad access to next-generation neuromodulation.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2497-2507"},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic and Hemodynamic Effects of Dexmedetomidine-Ketamine vs Fentanyl-Ketamine in Healthy Volunteers: A Randomized Trial.","authors":"Maja Green, Amie C Hayley, Luke A Downey, Michael Keane, Michaela Elise Kenneally, Krishnan Chakravarthy, Yahya Shehabi","doi":"10.2147/JPR.S514277","DOIUrl":"10.2147/JPR.S514277","url":null,"abstract":"<p><strong>Background: </strong>Dexmedetomidine is an α2-agonist sedative with opioid-sparing properties, is limited by dose-dependent hypotension and bradycardia. Ketamine, an NMDA receptor antagonist, has sympathomimetic effects and may attenuate these cardiovascular effects while contributing analgesia. Whether low-dose ketamine can stabilize dexmedetomidine-induced hemodynamic changes and provide comparable analgesia to an opioid-based regimen is uncertain.</p><p><strong>Methods: </strong>In this open-label trial, we enrolled 41 healthy volunteers aged 18 to 45 years. All participants received a ketamine infusion (0.3 mg/kg bolus, then 0.15 mg/kg/hour for 3 hours). At 90 minutes, participants were randomized to receive either dexmedetomidine (0.7 µg/kg/hour for 90 minutes, KET/DEX group) or fentanyl (three 25 µg boluses, KET/FENT group). The primary outcomes were change in blood pressure and pain tolerance (measured by pressure algometry). Secondary outcomes included heart rate, subjective mood and sedation, and adverse events. Data were analyzed using mixed-effects models and Fisher's exact tests.</p><p><strong>Results: </strong>Of 41 randomized participants, 39 completed the protocol (KET/DEX, 19; KET/FENT, 20). KET/DEX resulted in greater reductions in systolic blood pressure (mean decrease 35-40 mm Hg; ~25-30%) compared to KET/FENT (mean change minimal; between-group <i>P</i><0.001). Heart rate declined modestly with KET/DEX but did not differ significantly between groups. Both regimens increased pain tolerance to a similar degree (mean threshold rise ~30-50 kPa; between-group <i>P</i>=0.80). Participants in the KET/DEX group reported greater sedation and transient negative mood effects (eg, disinterest), while KET/FENT was associated with mild nausea in a minority. Clinically significant hypotension occurred in 4 participants (21%) in the KET/DEX group and in none of the KET/FENT group (<i>P</i>=0.047). All events were transient and responsive to fluid boluses. No respiratory depression occurred in either group.</p><p><strong>Conclusion: </strong>Ketamine plus dexmedetomidine produced analgesia equivalent to ketamine plus fentanyl but with more pronounced hypotension and deeper sedation. The hemodynamic effects of dexmedetomidine were not fully offset by low-dose ketamine. These findings suggest that while ketamine-dexmedetomidine may offer an opioid-sparing alternative, careful dose selection and monitoring are required to ensure tolerability. (Funded by Monash University and Monash Health; ACTRN12617000787381).</p><p><strong>Clinical trial number and registry url: </strong>https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372916.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2483-2496"},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Effect of Electroacupuncture Combined with Surround Needling in the Treatment of Acute Lateral Ankle Sprain Based on Musculoskeletal Ultrasound Imaging Technology: A Protocol for a Single-Centre, Randomized, Controlled Trial.","authors":"Liao Chen, Qimiao Hu, Hong Gao, Ding Tang","doi":"10.2147/JPR.S517109","DOIUrl":"10.2147/JPR.S517109","url":null,"abstract":"<p><strong>Objective: </strong>To verify the efficacy of electroacupuncture (EA) combined with surround needling on acute lateral ankle sprain (ALAS) based on musculoskeletal ultrasound (MSKUS) imaging technology.</p><p><strong>Methods and analysis: </strong>Sixty-six ALAS patients will be randomly divided into EA combined with surround needling group, sham EA group and ice combined with brake rest group in a 1:1:1 ratio by using a random number table. The Kofoed scores, MSKUS quantitative measurement and circumference of ankle joint will be compared to evaluate the differences in efficacy caused by the three treatment methods as stated. Data for the assessment will be collected at baseline, three-week treatment, and two-month follow-up in three groups of ALAS patients.</p><p><strong>Trial registration: </strong>ChiCTR-2300078874.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2467-2478"},"PeriodicalIF":2.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Intrathecal Sufentanil at Different Doses on Postoperative Pain Relief and Opioid Consumption in Elderly Patients Undergoing Lower Limb Orthopedic Surgery: A Randomized Controlled Trial.","authors":"Yan Li, Yinghua Gu, Wenxun Liu, Xin Liu, Fa Wang, Biyun Tian, Wei Zhou, Qingshan Ye","doi":"10.2147/JPR.S512653","DOIUrl":"10.2147/JPR.S512653","url":null,"abstract":"<p><strong>Introduction: </strong>Fine-needle isobaric spinal anesthesia is preferred for elderly patients undergoing lower limb fracture surgery. However, single-agent local anesthetics are limited by short block duration, hemodynamic instability, and inadequate analgesia. Intrathecal sufentanil, as an adjunct, enhances analgesia, prolongs block duration, and promotes recovery. Yet, the dose-dependent effects of intrathecal sufentanil remain understudied. This study evaluates different doses of intrathecal sufentanil in this population, aiming to optimize dosing through evidence-based strategies.</p><p><strong>Methods: </strong>We randomly allocated 231 elderly patients into three groups: Group B (bupivacaine only), Group BS1 (bupivacaine + 5 μg sufentanil), and Group BS2 (bupivacaine + 10 μg sufentanil). We assessed baseline data, sensory and motor block characteristics, NRS scores, rescue opioid consumption, and complications.</p><p><strong>Results: </strong>BS1 and BS2 had delayed motor block onset (median = 3 min) compared to Group B (median = 2 min), but significantly longer motor block duration (BS2: 279.5 min, P = 0.001; BS1: 268.0 min, P = 0.022 vs Group B: 223.0 min). On postoperative day 2, BS1 and BS2 showed lower NRS scores and less analgesic use than Group B. Nausea was most common in BS1, while pruritus increased in BS2. Hypoxemia was highest in BS2 on postoperative day 1.</p><p><strong>Conclusion: </strong>Bupivacaine and sufentanil combined is a safe and effective regimen, prolonging analgesia and reducing postoperative pain and opioid use. BS2 (bupivacaine + 10 μg sufentanil) provided the best pain relief, ideal for high pain control needs, but higher pruritus and hypoxemia in BS2 suggest careful dosage adjustment based on patient tolerance.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2439-2451"},"PeriodicalIF":2.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balanced Opioid-Free Anesthesia on Chronic Postsurgical Pain After Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Trial Protocol.","authors":"Wen-Wen Huo, Jia-Yu Qian, Han-Xue Zhao, Wei Dou, Shao-Mu Chen, Fu-Hai Ji, Ke Peng","doi":"10.2147/JPR.S519022","DOIUrl":"10.2147/JPR.S519022","url":null,"abstract":"<p><strong>Background: </strong>Opioids are widely used for anesthesia and postoperative analgesia; however, their use is related to increased risks of untoward effects including hyperalgesia and chronic postsurgical pain (CPSP). We aim to compare opioid-free anesthesia (OFA) with opioid-based anesthesia (OBA) on the incidence of CPSP after video-assisted thoracoscopic surgery (VATS).</p><p><strong>Methods: </strong>This randomized controlled clinical trial was approved by the Medical Ethics Committee of the First Affiliated Hospital of Soochow University, Suzhou, China. A total of 180 adult patients undergoing VATS lung resection will be randomized to receive one of two balanced anesthesia regimens: OFA (dexmedetomidine, esketamine, and sevoflurane) or OBA (sufentanil and sevoflurane). A standardized multimodal analgesia comprises erector spinae plane block, intravenous flurbiprofen axetil, and patient-controlled sufentanil analgesia. The primary outcome is the incidence of CPSP at 3 months after surgery. Secondary outcomes include acute postoperative pain at rest and while coughing (at discharge from post-anesthesia care unit and 6, 24 and 48 hours after surgery), the incidences of postoperative pain at 1 month and 6 months, postoperative 24- and 48-hour sufentanil consumption, adverse events (postoperative nausea and vomiting, headache, dizziness, hallucination, and nightmare), length of post-anesthesia care unit and hospital stay, and the 15-item quality of recovery scores at 48 hours after surgery.</p><p><strong>Discussion: </strong>We hypothesize that the OFA strategy would decrease the incidence of CPSP, reduce postoperative adverse events, and enhance quality of recovery following VATS procedures.</p><p><strong>Registration: </strong>Chinese Clinical Trial Registry (ChiCTR2400081099).</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2459-2466"},"PeriodicalIF":2.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absorbable Antibacterial Envelope Reduces Surgical Site Infections for Intrathecal Pain Pump Implants: A Retrospective Analysis.","authors":"Christopher L Robinson, Michael C Chiang, Akash S Patel, Kheng Sze Chan, Arti Ori, R Jason Yong, Samuel P Ang","doi":"10.2147/JPR.S519430","DOIUrl":"10.2147/JPR.S519430","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2479-2482"},"PeriodicalIF":2.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Of Intraarticular Corticosteroid Injections into the Cervical Facet Joint Based on Single-Photon Emission Computed Tomography Imaging.","authors":"Seoyon Yang, Min Cheol Chang","doi":"10.2147/JPR.S522930","DOIUrl":"10.2147/JPR.S522930","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic neck pain is a prevalent condition that significantly impairs quality of life and contributes to disability. The cervical facet joint (CFJ) is a common source of neck pain, and intraarticular (IA) corticosteroid injections are widely utilized for symptom relief. However, accurately predicting treatment outcomes remains challenging. This study aimed to evaluate the utility of bone single-photon emission computed tomography (SPECT) in predicting the therapeutic response to IA corticosteroid injections in patients with CFJ-origin neck pain.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on 102 patients who underwent IA CFJ corticosteroid injections between March 2010 and December 2020. Patients were stratified into two groups based on bone SPECT findings: those with increased CFJ radiotracer uptake (SPECT+ group, n=60) and those without (SPECT- group, n=42). Pain intensity was assessed using the numeric rating scale (NRS) before treatment and at the 1-month follow-up. Treatment success was defined as a ≥50% reduction in NRS scores. Statistical analyses were performed to compare outcomes between groups.</p><p><strong>Results: </strong>Both the SPECT+ and SPECT- groups exhibited significant pain reduction following IA corticosteroid injection (<i>P</i> < 0.001 for both groups). However, the SPECT+ group demonstrated significantly greater pain relief compared to the SPECT- group at the 1-month follow-up (<i>P</i> = 0.007). Furthermore, the treatment success rate was significantly higher in the SPECT+ group (63.3%) than in the SPECT- group (38.1%) (<i>P</i> = 0.012).</p><p><strong>Conclusion: </strong>Bone SPECT is a valuable imaging modality for predicting the therapeutic efficacy of IA corticosteroid injections in patients with CFJ-origin neck pain. The findings suggest that increased CFJ radiotracer uptake is associated with a greater likelihood of achieving significant pain relief, underscoring the potential role of inflammation in treatment response.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2453-2458"},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Workers' Pain Management-Correlated Barriers and Self-Efficacy at Teaching Hospitals in the City of Ismailia.","authors":"Fatma Mohamed Elmansy, Mohamed Goda Elbqry, Saddam Ahmed Al-Ahdal, Fatima S O Ashmieg, Samia Eaid Elgazzar, Patience Osose Nasir, Nasiru Mohammed Abdullahi","doi":"10.2147/JPR.S515344","DOIUrl":"10.2147/JPR.S515344","url":null,"abstract":"<p><strong>Aim: </strong>To determine healthcare workers' pain management-correlated barriers and self-efficacy at teaching hospitals in the city of Ismailia, Egypt.</p><p><strong>Methods: </strong>A descriptive study was enrolled. 117 healthcare workers (nurses and physicians) were recruited through a purposive sampling technique. An online valid closed-ended online questionnaire was used to collect data between June and December 2023 to assess demographic data, pain management-correlated barriers, and self-efficacy.</p><p><strong>Results: </strong>The findings indicated that medical staff, patients and families, and the healthcare system each perceived distinct barriers to care, with mean scores of 4.88 (SD = 0.56), 5.65 (SD = 1.74), and 3.11 (SD = 0.36), respectively. Furthermore, healthcare workers' self-efficacy was found to be moderate, with a mean score of 12.99 (SD = 4.02) A statistically significant difference (p ≤ 0.05) was found in healthcare workers' self-efficacy based on their workplace and years of experience.</p><p><strong>Conclusion: </strong>In the critical care setting, healthcare workers perceived correlated barriers as significant obstacles to successful pain management. High self-efficacy in pain management was reported among healthcare workers in the critical care unit. Effective pain management necessitates specialized training programs that incorporate diverse tools and consider patients' cultural backgrounds. Integrating cultural competence into academic curricula and hospital training programs is vital. Healthcare organizations and policymakers should prioritize addressing the identified barriers to improve healthcare delivery and outcomes.</p><p><strong>Study implication: </strong>Firstly, enhancing pain management practices is crucial in improving patient care. Identifying and addressing the barriers that healthcare professionals face in pain management. Improving healthcare workers' self-efficacy in pain management for consistent and effective care, reducing unnecessary suffering and bridge the gaps to improve overall patient outcomes.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2417-2425"},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Costotransverse Foramen Block with Thoracic Paravertebral Block and Erector Spinae Plane Block for Patients Undergoing Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Non-Inferiority Trial.","authors":"Jing Li, Peiqi Shao, Hong Wen, Danxu Ma, Lina Yang, Jianshuai He, Jia Jiang","doi":"10.2147/JPR.S518558","DOIUrl":"10.2147/JPR.S518558","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the safety and efficacy of costotransverse foramen block for postoperative analgesia in video-assisted thoracoscopic surgery (VATS).</p><p><strong>Patients and methods: </strong>Seventy-five patients undergoing elective VATS under general anaesthesia were recruited to this double-blind, non- inferiority trial and randomized to preoperatively receive a thoracic paravertebral block (TPVB group), a costotransverse foramen block (CTFB group), or an erector spinae plane block (ESPB group) with 0.5% ropivacaine 20 mL at T5 level. The primary outcome was the postoperative numerical rating scale pain score assessed at 6 h. Secondary outcomes included pain scores at other time points, total opioids consumption at 24 h postoperatively, time to first patient-controlled analgesia pump bolus, number of patients requiring rescue analgesia, dermatomal coverage at 30 min after block, time to perform the block, satisfaction scores of the analgesic effect, block-related side effects, and other complications. The health-related quality of life was evaluated one month after surgery.</p><p><strong>Results: </strong>The pain scores at 6 h after surgery were 0 (0, 3) in the TPVB group, 0 (0, 2) in the CTFB group, and 4 (3, 4) in the ESPB group. The 95% CI of median difference was 0 to 0 comparing CTFB with TPVB and -4 to -2 comparing CTFB with ESPB. Both the upper 95% CI limits were lower than the predefined noninferiority margin of 1. The pain scores at postanaesthesia care unit, 1 h, 6 h and 12 h after surgery, number of block dermatomes, patient satisfaction scores, time to perform the block as well as the time to first analgesia pump bolus were significantly different between the CTFB group and ESPB group. No differences were detected in other secondary outcomes.</p><p><strong>Conclusion: </strong>Ultrasound-guided CTFB provided noninferior analgesia compared to TPVB at 6 h after VATS. Additionally, CTFB might provide better analgesia to ESPB although larger confirmatory researches for superiority are further warranted.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"2427-2438"},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}