{"title":"肋间神经阻滞在单门静脉胸腔镜手术(VATS)中的优势和可行性。","authors":"Linlin Wang, Lihui Ge, Yi Ren","doi":"10.1080/00325481.2023.2187959","DOIUrl":null,"url":null,"abstract":"ABSTRACT Objectives Uniportal video-assisted thoracic surgery (VATS) has been successfully used worldwide as a minimally invasive method of thoracoscopic surgery. Although pain was significantly reduced after VATS, acute postoperative pain was still significant. This study aimed to assess the advantages and feasibility of intercostal nerve block in uniportal VATS. Methods We conducted a retrospective analysis of perioperative data from 280 consecutive patients who underwent uniportal VATS at our institution between May 2021 and February 2022. The patients were assigned to either Group A (142 patients with 3 intercostal nerves blocked) or Group B (138 patients with 5 intercostal nerves blocked). We analyzed the perioperative data of both groups and utilized repeated measures ANOVA to determine the difference in postoperative pain between the two groups across time. Results A total of 280 patients underwent successful uniportal VATS during the study period. There were no significant differences between Group A and Group B in terms of age, gender, pulmonary function, arterial blood gas analysis, laterality, incision location, nodule size, nodule location, operative time, blood loss, drainage time, length of hospital stays, tumor stage, or postoperative complications. Furthermore, no surgical or 30-day postoperative mortalities occurred. Using repeated measures ANOVA, we found that the intercostal nerve block had significant effects on the group, time, and interaction terms group × time (P < 0.05). Conclusion Intercostal nerve block is safe and effective, and is associated with simple, accurate, and high patient satisfaction as opposed to other postoperative analgesics in uniportal VATS. Blocking five intercostal nerves may be more beneficial for effective postoperative pain management. Nevertheless, further confirmation through prospective randomized controlled trials is required.","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 5","pages":"472-479"},"PeriodicalIF":2.6000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Advantages and feasibility of intercostal nerve block in uniportal video-assisted thoracoscopic surgery (VATS).\",\"authors\":\"Linlin Wang, Lihui Ge, Yi Ren\",\"doi\":\"10.1080/00325481.2023.2187959\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"ABSTRACT Objectives Uniportal video-assisted thoracic surgery (VATS) has been successfully used worldwide as a minimally invasive method of thoracoscopic surgery. Although pain was significantly reduced after VATS, acute postoperative pain was still significant. This study aimed to assess the advantages and feasibility of intercostal nerve block in uniportal VATS. Methods We conducted a retrospective analysis of perioperative data from 280 consecutive patients who underwent uniportal VATS at our institution between May 2021 and February 2022. The patients were assigned to either Group A (142 patients with 3 intercostal nerves blocked) or Group B (138 patients with 5 intercostal nerves blocked). We analyzed the perioperative data of both groups and utilized repeated measures ANOVA to determine the difference in postoperative pain between the two groups across time. Results A total of 280 patients underwent successful uniportal VATS during the study period. There were no significant differences between Group A and Group B in terms of age, gender, pulmonary function, arterial blood gas analysis, laterality, incision location, nodule size, nodule location, operative time, blood loss, drainage time, length of hospital stays, tumor stage, or postoperative complications. Furthermore, no surgical or 30-day postoperative mortalities occurred. Using repeated measures ANOVA, we found that the intercostal nerve block had significant effects on the group, time, and interaction terms group × time (P < 0.05). Conclusion Intercostal nerve block is safe and effective, and is associated with simple, accurate, and high patient satisfaction as opposed to other postoperative analgesics in uniportal VATS. Blocking five intercostal nerves may be more beneficial for effective postoperative pain management. Nevertheless, further confirmation through prospective randomized controlled trials is required.\",\"PeriodicalId\":20329,\"journal\":{\"name\":\"Postgraduate Medicine\",\"volume\":\"135 5\",\"pages\":\"472-479\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Postgraduate Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/00325481.2023.2187959\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Postgraduate Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/00325481.2023.2187959","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Advantages and feasibility of intercostal nerve block in uniportal video-assisted thoracoscopic surgery (VATS).
ABSTRACT Objectives Uniportal video-assisted thoracic surgery (VATS) has been successfully used worldwide as a minimally invasive method of thoracoscopic surgery. Although pain was significantly reduced after VATS, acute postoperative pain was still significant. This study aimed to assess the advantages and feasibility of intercostal nerve block in uniportal VATS. Methods We conducted a retrospective analysis of perioperative data from 280 consecutive patients who underwent uniportal VATS at our institution between May 2021 and February 2022. The patients were assigned to either Group A (142 patients with 3 intercostal nerves blocked) or Group B (138 patients with 5 intercostal nerves blocked). We analyzed the perioperative data of both groups and utilized repeated measures ANOVA to determine the difference in postoperative pain between the two groups across time. Results A total of 280 patients underwent successful uniportal VATS during the study period. There were no significant differences between Group A and Group B in terms of age, gender, pulmonary function, arterial blood gas analysis, laterality, incision location, nodule size, nodule location, operative time, blood loss, drainage time, length of hospital stays, tumor stage, or postoperative complications. Furthermore, no surgical or 30-day postoperative mortalities occurred. Using repeated measures ANOVA, we found that the intercostal nerve block had significant effects on the group, time, and interaction terms group × time (P < 0.05). Conclusion Intercostal nerve block is safe and effective, and is associated with simple, accurate, and high patient satisfaction as opposed to other postoperative analgesics in uniportal VATS. Blocking five intercostal nerves may be more beneficial for effective postoperative pain management. Nevertheless, further confirmation through prospective randomized controlled trials is required.
期刊介绍:
Postgraduate Medicine is a rapid peer-reviewed medical journal published for physicians. Tracing its roots back to 1916, Postgraduate Medicine was established by Charles Mayo, MD, as a peer-to-peer method of communicating the latest research to aid physicians when making treatment decisions, and it maintains that aim to this day. In addition to its core subscriber base, Postgraduate Medicine is distributed to hundreds of US-based physicians within internal medicine and family practice.