Intracavitary anaesthesia for medical thoracoscopy procedural pain: the CAMP randomised trial

Abdelhady, Ahmed M.; Gadallah, Mohamed M.; Shaheen, Moustafa; Mourad, Sahar; Hassan, Maged

doi:10.1186/s43168-021-00091-w

Cited by 4 publications

(2 citation statements)

References 11 publications

(15 reference statements)

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“…Despite the non-inferiority trial of Grendelmeier et al [ 32 ] showing that propofol led to a higher incidence of hypoxaemia and hypotension when compared to midazolam, Tschopp et al demonstrated that bispectral index guided propofol was a safe method of sedation and facilitated early discharge following the procedure [ 33 ]. Other methods of analgesia, including intercostal nerve block, erector spinae plane block or intrapleural lidocaine via semi-rigid thoracoscopes, have been utilised [ 34 , 35 , 36 ]. There is no standardisation for any sedation method.…”

Section: Technique Sedation and Complicationsmentioning

confidence: 99%

Local Anaesthetic Thoracoscopy for Pleural Effusion—A Narrative Review

Jackson

Panchal

et al. 2022

Healthcare

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The incidence of pleural disease is increasing, and interventions are crucial in this subspecialist area of respiratory medicine. One of the cornerstones of pleural effusion investigation and management is medical, which is also known as local anaesthetic thoracoscopy. This allows fluid drainage, biopsy for diagnosis and preventative measures for further fluid potential build-up. This article summarises the evidence around this procedure through a narrative review of the available evidence.

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Section: Technique Sedation and Complicationsmentioning

confidence: 99%

Local Anaesthetic Thoracoscopy for Pleural Effusion—A Narrative Review

Jackson

Panchal

et al. 2022

Healthcare

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“…Midpoint transverse process to pleura blocks have been described [ 11 ] as well as multi-level intercostal nerve blocks [ 12 ] and paravertebral blocks [ 13 ]. Intracavitary anesthesia has also been trialed via a small single centre pilot study, with no difference in pain scores between the two groups [ 14 ]. All these single centre studies are limited by the same factors as our single centre project: the impossibility of generalization, lack of appropriate randomization, small patient numbers but taken together, they form the basis for the creation of a large formal randomised controlled trial with multiple analgesic arms with patient related outcome measures.…”

mentioning

confidence: 99%

Erector spinae plane blocks for day-case medical thoracoscopy: a pilot clinical study

McPherson

Halvey

Aujayeb

2022

Pleura and Peritoneum

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Objectives Erector spinae plane (ESP) blocks are a regional anaesthetic technique used for pain relief in thoracic procedures. Our centre has recently begun using ESP blocks pre-medical thoracoscopy for analgesia. Methods Nine patients undergoing MT from September 2021 to February 2022 were included. Opioid use and depth of required sedation was recorded. Pre and post pain scores and at home were recorded by interview and review of charts. A functional pain questionnaire was administered via telephone. Results Average greatest depth of sedation using propofol was 1.92 (standard error of mean [SEM] 0.27), with remifentanil 2.52 (SEM 0.46). 78% required oral analgesia on day 0 post discharge. 55% required oral analgesia on post-op day 1. Patients used an average of 3.33 mg oral morphine (SEM 2.35) in hospital, and 3 mg (SEM 2) on post-op day 1. Periprocedural pain scores were 0.66 (SEM 0.27). Pain scores in recovery were 1.56 (SEM 0.76). Pain scores 3–12 h post discharge were 3.56 (SEM 0.7), while pain scores on post-op day 1 were significantly higher at 5.56 (SEM 0.90) (Figure 1). Functional pain scoring showed patients doing activities of daily living well with a good ability to breathe and cough. All felt that their pain was well controlled on the day of the procedure and at home. No complications were reported. Conclusions ESP blocks provide good analgesia. Pain scores showed significant analgesic effect lasting several hours. The project showed pain outcomes and patient acceptability were good for the use of regional anaesthesia.

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