Postoperative analgesic effect of acupotomy combined with patient-controlled intravenous analgesia in patients undergoing video-assisted thoracoscopic surgery: A study protocol for a randomized controlled trial

Abstract

Background: Postoperative acute pain is a common issue following thoracic surgery. Acupotomy is a common and safe intervention method for pain treatment in the clinic. In previous preliminary experiments, we found that acupotomy has a good clinical effect and safety in the treatment of pain after thoracoscopic surgery. However, due to a lack of rigorous design and adequate sample size, the efficacy still needs to be further confirmed. The purpose of this study will be to explore the efficacy and safety of acupotomy combined with patient-controlled intravenous analgesia (PCIA) for the treatment of pain after video-assisted thoracic surgery (VATS). Methods: The study will be a single-centre, parallel group, randomized controlled trial. Seventy patients with significant pain after thoracoscopic surgery with a visual analogue scale (VAS) score ≥7 will be included and randomly distributed into two groups: G1, the acupotomy combined with PCIA group; or G2, the conventional PCIA group. The primary outcome measure is pain scores at rest and coughing evaluated with the VAS by a blinded observer in the PACU and postoperatively at 1, 2, 4, 8, 12, 24, 48 and 72 h. The secondary outcome measures are postoperative requirements for rescue analgesia, the cumulative amount of self-administered analgesics, the level of sedation (LOS), Bruggemann comfort scale (BCS), and functional activity score (FAS) concerning adverse effects and patient satisfaction. Discussion: This trial has the potential to identify a novel strategy for postoperative pain management in VATS. Findings may advocate for the inclusion of the treatment of comorbid pain after thoracoscopy in current pain management practice guidelines.