Effect of intercostal nerve block combined with general anesthesia on the stress response in patients undergoing minimally invasive mitral valve surgery

Yang, Zhan; Guo, Chen; Huang, Jen-Fa; Hou, Benchao; Liu, Weicheng; Chen, Shibiao

doi:10.3892/etm.2017.4868

Cited by 23 publications

(41 citation statements)

References 33 publications

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“… Low range of quality score. [32] China Minimally invasive mitral valve surgery. Major 30 Group A = patients received intercostal nerve block combined with GA. Group B = patients received GA alone.…”

Section: Resultsmentioning

confidence: 99%

“…Only one study, in patients undergoing laparoscopic colorectal resection, ( n = 120) compared the combination of GA plus spinal anesthesia (bupivacaine and diamorphine) to GA plus postoperative patient controlled analgesia (PCA) with morphine and did not show any significant effect on the mean peak CRP (42 mg/L versus 58 mg/L, P -value not given) [31] . In addition, a single study in cardiac surgery ( n = 30), compared GA with or without intercostal nerve block, reporting significantly lower peak IL-6 in the combined intercostal / GA group (2200 pg/mL versus 1300 pg/mL, P < .001) [32] .…”

Section: Resultsmentioning

confidence: 99%

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The effect of anesthesia on the postoperative systemic inflammatory response in patients undergoing surgery: A systematic review and meta-analysis

Alhayyan

McSorley

Roxburgh

et al. 2020

Surgery Open Science

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Background Surgical injury stimulates the systemic inflammatory response. The magnitude of the postoperative systemic inflammatory response has been shown to be significantly associated with short and long-term outcomes following surgery of varying severity. Different anesthetic techniques for surgery may have an impact on the postoperative systemic inflammatory response and on the rate of the postoperative infective complications. The aim of the present systematic review was to examine the relationship between perioperative anesthesia, the postoperative systemic inflammatory response and postoperative infective complications in patients undergoing surgery. Methods This was carried out using PubMed and other established databases from 1987 up to March 2018. In particular, randomized controlled studies and systemic inflammation markers, interleukin 6 and C-reactive protein were examined. Results Overall, 60 controlled, randomized clinical trials were included in the review. The mean or median values of both interleukin 6 and C-reactive protein were taken for each study and the mean value was calculated for each anesthetic group at sampling points of 12–24 and 24–72 hours for interleukin 6 and C-reactive protein respectively. When taking the magnitude of surgery into account, TIVA using propofol was significantly associated with a reduction in particular C-reactive protein ( P = .04). However, there were no other specific anesthetic methods including general, regional and combined anesthetics that were associated with a reduction in either interleukin 6 or C-reactive protein. Conclusion There is some evidence that anesthetic regimens may reduce the magnitude of the postoperative systemic inflammatory response. However, the studies were heterogeneous and generally of low quality. Future, well conducted, adequately powered studies are required to clarify the effect of anesthesia on the postoperative systemic inflammatory response and infective complications.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The effect of anesthesia on the postoperative systemic inflammatory response in patients undergoing surgery: A systematic review and meta-analysis

Alhayyan

McSorley

Roxburgh

et al. 2020

Surgery Open Science

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show abstract

“…The use of a catheter inserted in close proximity to intercostal space before skin closure with administration of 75 mg of 0.75% ropivacaine has been shown to eliminate early postoperative pain. 38 Alternatively, intercostal nerve blockade combined with general anaesthesia has also been reported, 50 which was achieved by the administration of 0.5% ropivacaine from T3 to T7 prior to anaesthesia induction. Intractable cases of chronic pain secondary to intercostal nerve traction is likely to require input from neuropathic pain specialists to employ patient-specific therapy.…”

Section: Dealing With Adverse Eventsmentioning

confidence: 99%

BISMICS consensus statement: implementing a safe minimally invasive mitral programme in the UK healthcare setting

et al. 2020

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Disseminating the practice of minimally invasive mitral surgery (mini-MVS) can be challenging, despite its original case reports a few decades ago. The penetration of this technology into clinical practice has been limited to centres of excellence, and mitral surgery in most general cardiothoracic centres remains to be conducted via sternotomy access as a first line. The process for the uptake of mini-MVS requires clearer guidance and standardisation for the processes involved in its implementation. In this statement, a consensus agreement is outlined that describes the benefits of mini-MVS, including reduced postoperative bleeding, reduced wound infection, enhanced recovery and patient satisfaction. Technical considerations require specific attention and can be introduced through simulation and/or use in conventional cases. Either endoballoon or aortic cross clamping is recommended, as well as femoral or central aortic cannulation, with the use of appropriate adjuncts and instruments. A coordinated team-based approach that encourages ownership of the programme by the team members is critical. A designated proctor is also recommended. The organisation of structured training and simulation, as well as planning the initial cases, is an important step to consider. The importance of pre-empting complications and dealing with adverse events is described, including re-exploration, conversion to sternotomy, unilateral pulmonary oedema and phrenic nerve injury. Accounting for both institutional and team considerations can effectively facilitate the introduction of a mini-MVS service. This involves simulation, team-based training, visits to specialist centres and involvement of a designated proctor to oversee the initial cases.

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“…Zhan и соавт. в своем исследовании сравнили влияние межреберной блокады в сочетании с общей анестезией при миниинвазивных вмешательствах на митральном клапане на развитие стрессорного ответа на операцию, а также стандартные показатели послеоперационного восстановления [23]. В исследование были включены 30 пациентов, по 15 в каждой из групп (группа А -с применением регионарной блокады, группа В -без нее), все исследуемые сравнимы по возрасту, полу, антропометрическим характеристикам, классу ASA, продолжительности операции и ИК.…”

Section: межреберная блокада нервовunclassified

“…Кроме того, применение межреберной блокады позволило уменьшить общее потребление суфентанила (р<0,001), обеспечить раннюю экстубацию (р<0,001), уменьшить продолжительность пребывания в отделении интенсивной терапии (р<0,01) и снизить уровень болевого синдрома, оцененного с помощью ВАШ в 1-е сутки после операции (р<0,001) [23]. Следует отметить, что в данном исследовании инъекция местного анестетика была однократной.…”

Section: обзоры литературы Reviewunclassified

Analgesia after cardiac surgery

Зозуля¹,

Lenkin²,

Kurapeev³

et al. 2019

Anesteziologiya I Reanimatologiya

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РЕЗЮМЕ В статье дано определение понятия послеоперационной боли, описаны особенности болевого синдрома после кардиохирургических вмешательств. Основное внимание уделено методам и методикам обезболивания в послеоперационном периоде: рассмотрен стандартный метод обезболивания опиоидами и нестероидными противовоспалительными средствами, его недостатки и побочные эффекты, оценены регионарные методики, применимые к кардиохирургии. Изложены современные представления о мультимодальной аналгезии, адъювантах, нашедших применение в кардиохирургии, таких как габапентиноиды, лидокаин, дексмедетомидин и кетамин.

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Effect of intercostal nerve block combined with general anesthesia on the stress response in patients undergoing minimally invasive mitral valve surgery

Cited by 23 publications

References 33 publications

The effect of anesthesia on the postoperative systemic inflammatory response in patients undergoing surgery: A systematic review and meta-analysis

The effect of anesthesia on the postoperative systemic inflammatory response in patients undergoing surgery: A systematic review and meta-analysis

BISMICS consensus statement: implementing a safe minimally invasive mitral programme in the UK healthcare setting

Analgesia after cardiac surgery

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