Repetitive Intercostal Nerve Block via Catheter for Postoperative Pain Relief after Thoracotomy

Kolvenbach, H.; Lauven, P. M.; Schneider, Bernard L.; Kunath, U.

doi:10.1055/s-2007-1020331

Cited by 9 publications

(19 citation statements)

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“…The remaining 86 full-text articles were assessed for eligibility, and 20 of those articles were excluded (5 were not written in the English language, 4 included interventions that were mislabeled as ICNB, 3 did not include a group of patients who received ICNB with local anesthesia, 3 were systematic reviews, 2 were editorials or short reports, 1 examined outcomes outside the scope of the present study, 1 had insufficient reporting, and 1 examined nonthoracic surgery). All of the remaining 66 studies 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ,…”

Section: Resultsmentioning

confidence: 99%

“…Among 66 studies 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , ...…”

Section: Resultsunclassified

“…Because analgesic techniques vary based on the type of surgery performed, we divided the populations accordingly. Thirty-nine studies 20 , 21 , 22 , 23 , 24 , 25 , 27 , 28 , 29 , 30 , 32 , 33 , 34 , 36 , 38 , 39 , 40 , 44 , 45 , 46 , 47 , 48 , 49 , 60 , 64 , 65 , 66 , 67 , 68 , 70 , 73 , 74 , 76 , 77 , 78 , 79 , 80 , 81 , 82 (1805 patients) examined thoracotomy, 20 studies 26 , 41 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 61 , 62 , 63 , 69 , 71 , 75 , 84 , 85 (2512 patient...…”

Section: Resultsmentioning

confidence: 99%

“…The intervention used was single-injection ICNB in 51 studies 20 , 21 , 22 , 23 , 24 , 25 , 26 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 39 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 50 , 51 , 52 , 53 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 64 , 65 , 67 , 68 , 69 , 70 , 71 , 72 , 74 , 75 , 76 , 78 , 79 , 81 , 83 , 84 , 85 (4690 patients) and continuous ICNB in 15 studies 27 , 28 , 35 , 37 , 38 , 40 , 49 , 54 , 62 ,…”

Section: Resultsmentioning

confidence: 99%

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Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery

et al. 2021

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IMPORTANCEThe use of intercostal nerve block (ICNB) analgesia with local anesthesia is common in thoracic surgery. However, the benefits and safety of ICNB among adult patients undergoing surgery is unknown. OBJECTIVE To evaluate the analgesic benefits and safety of ICNB among adults undergoing thoracic surgery.DATA SOURCES A systematic search was performed in Ovid MEDLINE, Ovid Embase, Scopus, and the Cochrane Library databases using terms for ICNB and thoracic surgery (including thoracic surgery, thoracoscopy, thoracotomy, nerve block, intercostal nerves). The search and results were not limited by date, with the last search conducted on July 24, 2020.STUDY SELECTION Selected studies were experimental or observational and included adult patients undergoing cardiothoracic surgery in which ICNB was administered with local anesthesia via single injection, continuous infusion, or a combination of both techniques in at least 1 group of patients. For comparison with ICNB, studies that examined systemic analgesia and different forms of regional analgesia (such as thoracic epidural analgesia [TEA], paravertebral block [PVB], and other techniques) were included. These criteria were applied independently by 2 authors, and discrepancies were resolved by consensus. A total of 694 records were selected for screening. DATA EXTRACTION AND SYNTHESIS This study followed the Preferred Reporting Items forSystematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data including patient characteristics, type of surgery, intervention analgesia, comparison analgesia, and primary and secondary outcomes were extracted independently by 3 authors. Synthesis was performed using a fixed-effects model. MAIN OUTCOMES AND MEASURESThe coprimary outcomes were postoperative pain intensity (measured as the worst static or dynamic pain using a validated 10-point scale, with 0 indicating no pain and 10 indicating severe pain) and opioid consumption (measured in morphine milligram equivalents [MMEs]) at prespecified intervals (0-6 hours, 7-24 hours, 25-48 hours, 49-72 hours, and >72 hours). Clinically relevant analgesia was defined as a 1-point or greater difference in pain intensity score at any interval. Secondary outcomes included 30-day postoperative complications and pulmonary function. RESULTSOf 694 records screened, 608 were excluded based on prespecified exclusion criteria.The remaining 86 full-text articles were assessed for eligibility, and 20 of those articles were excluded. All of the 66 remaining studies (5184 patients; mean [SD] age, 53.9 [10.2] years; approximately 59% men and 41% women) were included in the qualitative analysis, and 59 studies (continued)

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Section: Resultsmentioning

confidence: 99%

Section: Resultsunclassified

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery

et al. 2021

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“…Repeated intercostal nerve blocks performed postoperatively are painful and time consuming and catheter techniques have been described (64)(65)(66). However, as spread from one intercostal space to another is unreliable, up to four catheters, inserted in the posterior axillary line have been described (67).…”

Section: Intercostal Blocksmentioning

confidence: 99%

Thoracic paravertebral analgesia

Richardson

Sabanathan

1995

Acta Anaesthesiol Scand

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Thoracic paravertebral nerve blockade, although once widely practised, has now only a few centres which contribute to the literature. Data production has, however, continued and this review correlates this new information with existing knowledge. Its history, taxonomy, anatomy, indications, techniques, mechanisms of analgesia, efficacy, contraindications, toxicity, side effects and complications are reviewed. Thoracic paravertebral analgesia is advocated for surgical procedures of the thorax and abdomen, especially wherever the afferent input is predominantly unilateral eg. thoracotomy, cholecystectomy and nephrectomy. It is also of benefit in the prevention and management of chronic pain. It is a simple undertaking with impressive efficacy. Plasma local anaesthetic levels are acceptable and its side effect and complication rates are low. No mortality has been reported. For unilateral surgery of the chest or truck, thoracic paravertebral analgesia should be considered as the afferent block of choice. For bilateral surgery, its efficacy may be limited by the doses of local anaesthetic which could safely be used and further study in this area in particular is required. This form of afferent blockade deserves greater consideration and investigation.

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Absorbable biopolymers derived from dimer fatty acids

Domb

Maniar

1993

J. Polym. Sci. A Polym. Chem.

110

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A new class of aliphatic copolyanhydrides was synthesized from nonlinear hydrophobic dimers (FAD) of erucic acid and sebacic acid which possessed the desired physico‐chemical and mechanical properties for use as a carrier for drugs. The polymers were synthesized by melt condensation to yield film‐forming polymers with molecular weights of 250,000. The copolymer composition was determined by 1H‐NMR and gravimetric methods. In vitro degradation studies showed that these polymers degrade following a first‐order kinetics with a rapid degradation in the first 10 days leaving a residue which is mostly the FAD comonomer. The drug release from the polymer also followed a first‐order kinetics which correlates with the degradation process of the polymer. Drugs like carboplatin, methotrexate, tetracycline, and gentamicin were released in vitro for over 2 weeks and in some cases over 6 weeks. In vivo biocompatibility tests in rats and rabbits in the brain, muscle, and subcutaneously, demonstrated their toxicological inertness and biodegradability. The 1 : 1 copolymer of FAD : SA was selected as a carrier for various applications including a gentamicin‐releasing implant which is now undergoing human clinical trials for the treatment of osteomyelitis. © 1993 John Wiley & Sons, Inc.

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Repetitive Intercostal Nerve Block via Catheter for Postoperative Pain Relief after Thoracotomy

Cited by 9 publications

References 1 publication

Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery

Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery

Thoracic paravertebral analgesia

Absorbable biopolymers derived from dimer fatty acids

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