Analgesic effect of intercostal nerve block given preventively or at the end of operation in video-assisted thoracic surgery: a randomized clinical trial

Xiao, Weizhang; Zhou, Weiwei; Chen, Xinming; Zhu, Junwu; Xue, Qun; Shi, Jiahai

doi:10.1016/j.bjane.2021.07.010

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…The Prince-Henry scale is an optimized pain scale for thoracic surgery (0 = no pain on coughing, 1 = pain on coughing or movement but not on deep breathing, 2 = pain on deep breathing but not at rest, 3 = slight pain at rest, and 4 = severe pain at rest). [23][24][25] The DN4 questionnaire has a high specificity in identifying neuropathic pain (a total score of 0−10 and a score ≥4 points indicating neuropathic pain). 19,21…”

Section: Study Planmentioning

confidence: 99%

Protocol for Development and Validation of Multivariable Prediction Models for Chronic Postsurgical Pain Following Video-Assisted Thoracic Surgery

Hu¹,

Shi²,

Han³

et al. 2023

JPR

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Chronic postsurgical pain (CPSP) is a common complication after thoracic surgery and associated with long-term adverse outcomes. This study aims to develop two prediction models for CPSP after video-assisted thoracic surgery (VATS). Methods and Analysis: This single-center prospective cohort study will include a total of 500 adult patients undergoing VATS lung resection (n = 350 for development and n = 150 for external validation). Patients will be enrolled continuously at The First Affiliated Hospital of Soochow University in Suzhou, China. The cohort for external validation will be recruited in another time period. The outcome is CPSP, which is defined as pain with the numerical rating scale score of 1 or higher 3 months after VATS. Univariate and multivariable logistic regression analyses will be performed to develop two CPSP prediction models based on patients' data of postoperative day 1 and day 14, respectively. For internal validation, we will use the bootstrapping validation technique. For external validation, the discrimination capability of the models will be assessed using the area under the receiver operating characteristic curve, and the calibration will be evaluated using the calibration curve and Hosmer-Lemeshow goodness-of-fit statistic. The results will be presented in model formulas and nomograms. Conclusion: Based on the development and validation of the prediction models, our results contribute to early prediction and treatment of CPSP after VATS. Trial Registration: Chinese Clinical Trial Register (ChiCTR2200066122).

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Section: Study Planmentioning

confidence: 99%

Protocol for Development and Validation of Multivariable Prediction Models for Chronic Postsurgical Pain Following Video-Assisted Thoracic Surgery

Hu¹,

Shi²,

Han³

et al. 2023

JPR

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“…The intercostal nerve block is a convenient and effective method to improve post-operative pain in thoracic surgery and has been widely used in clinical practices. Previous studies showed that intrapleural intercostal nerve block with mini-thoracotomy could reduce the post-operative pain and contribute to improving post-operative outcomes after major pulmonary resections ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of Preoperative Thoracic Paravertebral Blocks on Emergence Agitation During Tracheal Extubation: A Randomized Controlled Trial

Liu

Luo²,

Wang³

et al. 2022

Front. Med.

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ObjectiveThis study aims to compare the effects of preoperative thoracic paravertebral blocks (TPVB) with intercoastal nerve blocks (ICNB) on emergence agitation (EA) during tracheal extubation in patients who underwent thoracoscopic lobectomy.Design, Setting, and ParticipantsA randomized clinical trial was conducted in patients undergoing thoracoscopic lobectomy at Beijing Chest Hospital between June 2019 and December 2020.InterventionsPatients were randomly assigned 1:1 to receive either ultrasound-guided preoperative TPVB or ICNB.Main Outcomes and MeasuresThe primary outcome was the occurrence of emergency agitation, which was evaluated by Aono’s four-point scale (AFPS). Secondary outcomes included hemodynamics [mean arterial pressure (MAP) and heart rate (HR)]; and post-operative pain intensity [visual analog scale (VAS), Ramsay sedation score (RSS), and patient-controlled analgesia (PCA) demand times].ResultsAmong the 100 patients aged 55–75 years old, 50 were randomized to each group; 97 patients completed the trial. Compared to the ICNB group, the occurrence of EA in the TPVB group was significantly lower [31.3% (15/48) vs. 12.2% (6/49), relative risk = 1.276, 95% CI: 1.02–1.60, P = 0.028]. For patients in the TPVB group, the MAP and HR at 5, 10, and 30 min after extubation were significantly lower; the intraoperative details including emergence time, extubation time, and consumption of sufentanil were significantly shorter than that in the ICNB group. Additionally, patients in the TPVB group showed significantly lower VAS at rest or coughing and significantly lower RSS at 60 and 240 min after extubation than patients in the ICNB group (all P < 0.05).ConclusionPreoperative TPVB was associated with less EA during tracheal extubation when compared with ICNB in patients undergoing thoracoscopic lobectomy.Clinical Trial Registration[http://www.chictr.org.cn/index.aspx], identifier [ChiCTR1900023852].

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“…Thus, Xiao et al, in a study also available in the current issue, revealed that INB provided better analgesia for video thoracoscopes when performed preemptively. 31 Better understanding of the mechanism of action, distribution, systemic absorption, interaction with multimodal analgesia, and benefits in comparison to other techniques should be continuously encouraged.…”

mentioning

confidence: 99%

Anesthesiology and pain medicine

Barros

Kraychete

Lineburger³

et al. 2022

Brazilian Journal of Anesthesiology (English Edition)

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Analgesic effect of intercostal nerve block given preventively or at the end of operation in video-assisted thoracic surgery: a randomized clinical trial

Cited by 5 publications

References 22 publications

Protocol for Development and Validation of Multivariable Prediction Models for Chronic Postsurgical Pain Following Video-Assisted Thoracic Surgery

Protocol for Development and Validation of Multivariable Prediction Models for Chronic Postsurgical Pain Following Video-Assisted Thoracic Surgery

Effect of Preoperative Thoracic Paravertebral Blocks on Emergence Agitation During Tracheal Extubation: A Randomized Controlled Trial

Anesthesiology and pain medicine

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