Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial

Ahmed, Zulfiqar; Samad, Khalid; Ullah, Hameed

doi:10.4103/1658-354x.197342

Cited by 27 publications

(26 citation statements)

References 12 publications

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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%

“…Among 59 studies 20 , 22 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 65 , 66 , 67 , 68 , 69 , 71 , 72 , 73 , 74 , 77 , 78 , 79 , 80 , 81 , 83 , 84 included in the quantitative meta-analysis, 54 studies 20 , 22 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ...…”

Section: Resultsunclassified

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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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