The Effect of Preoperative Ultrasound-Guided Erector Spinae Plane Block on Chronic Postsurgical Pain After Breast Cancer Surgery: A Propensity Score-Matched Cohort Study

Xin, Ling; Hou, Ning; Zhang, Ziyan; Feng, Yi

doi:10.1007/s40122-021-00339-9

Cited by 7 publications

(3 citation statements)

References 40 publications

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“…In our study, we found that 34.5% of patients with chronic pain (19.4% of all the patients) showed a neuropathic characteristic with the ID-Pain method. 19,20 Similarly, a comparable prevalence (25%) had been reported by Mongardon N. 20 Moreover, we learned that 47.1% of patients who suffered moderate and severe pain 1 month after the surgery had neuropathological agony, whereas only 10.6% of patients with mild pain had that. Meanwhile, among 29 patients who had neuropathological pain, 28 still suffered 6-month postoperative agony.…”

supporting

confidence: 82%

Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery

Zhao¹,

Li²,

Wang³

et al. 2022

JPR

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Background Patients undergoing video-assisted thoracoscopic surgery (VATS) frequently suffered postoperative acute and chronic pains. In recent years, intrathoracic intercostal nerve block (INB) is regularly used thanks to its safety and accuracy, especially under the circumstance of lacking ultrasound or in face of the contraindications of the thoracic paravertebral block (TPVB). However, clinical evidence of comparing TPVB and INB for pain management after VATS has been limited and the observation of the chronic pain has been less than clear. Methods A total of 180 patients undergoing VATS were randomly divided into three groups: A single multi-point paravertebral nerve block (Group P), intrathoracic intercostal nerve block (Group I), and general anesthesia without any regional block (Group C). Postoperative acute pain was scored at rest and coughing by the Visual Analog Scale (VAS) for recording 24h, 48h and 72h after VATS. All patients were interviewed 1, 3 and 6 months after the surgery to investigate both the incidence and intensity of chronic pains. Results There were significantly less incidence and intensity of acute pain in Group P and Group I, compared to those in Group C. The patients in Group I showed the least incidence and intensity of chronic pain after 3 months compared with those in Group P and Group C. There are 89 of 98 patients suffering pains after 1 month, which grew into chronic pains after 3 months and 78 of them still suffered chronic pains even after 6 months. Conclusion The intrathoracic INB offers excellent relief from acute and chronic pains, which does as effectively as TPVB. Besides, one-month postoperative pain could increase the risk of a chronic one.

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confidence: 82%

Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery

Zhao¹,

Li²,

Wang³

et al. 2022

JPR

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“…Fourth, rare complications including pneumothorax or large vessel injury could not be assessed, and larger sample sizes could be required to analyse rare incidents. Finally, ESPB and SAPB may play a signi cant role in avoiding postoperative chronic pain [48,49]. However, none of the included studies evaluated the e cacy of ESPB and SAPB for chronic pain, and more RCTs and longer follow-up are needed to assess the long-term e cacy of both.…”

Section: Discussionmentioning

confidence: 99%

Comparing ultrasound-guided serratus anterior plane block with erector spinae plane block for postoperative analgesia in thoracic and breast surgery: A systematic review and meta-analysis

Zhang

Huang

et al. 2023

Preprint

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Background: Serratus anterior plane block (SAPB) was first proposed in 2013 as a new method for regional nerve block, while erector spinae plane block (ESPB) was first proposed in 2016. Both regional nerve block techniques can be used for analgesia in thoracic and breast surgery, but the debate about their actual effects continues. The purpose of this systematic review was to compare the analgesic effects of these two nerve block techniques after thoracic and breast surgery. Methods: We systematically searched the PubMed, Embase, Web of Science and Cochrane Library databases up to August 2022. We performed a meta-analysis of clinical randomized controlled trials (RCTs) comparing the effects of SAPB and ESPB on postoperative analgesia in patients undergoing thoracic and breast surgery. Results: A total of 11 RCTs were included. Meta-analysis revealed that compared with the SAPB group, patients in the ESPB group had significantly reduced 24-hour postoperative opioid consumption (standardized mean difference [SMD]: -0.76; 95% confidence interval [CI]: -1.29 to -0.24; P < 0.01; I2=88%). Rest or movement pain scores were significantly lower at various time points postoperatively. In addition, ESPB-group patients had significantly reduced intraoperative opioid consumption (SMD: -0.43; 95% CI: -0.64 to -0.23; P<0.001; I2=35%). In terms of time to first use of analgesics, ESPB significantly prolonged the time to first analgesic use (SMD: 3.53; 95% CI: 1.62 to 5.44; P < 0.001; I2 = 97%). Conclusions: Compared with SAPB, ESPB is more effective in analgesia after thoracic and breast surgery, especially in thoracic surgery.

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“…In addition, TEB is regarded as the gold standard for postoperative analgesia, and TPVB is the most representative region block technique. Intrathoracic INB is a frequently used technique due to its safety, convenience, and accuracy [ 10 , 14 , 23 ]. These 3 methods are the most common techniques for acute pain relief after VATS, and their effects have been confirmed by numerous studies.…”

Section: Discussionmentioning

confidence: 99%

The effects of different analgesic methods on chronic pain in patients undergoing video-assisted thoracoscopic surgery.

Zhao¹,

Xiao²,

Zhang³

et al. 2022

Videosurgery and Other Miniinvasive Techniques

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Introduction: Thoracic epidural block, paravertebral block, and intercostal nerve block have been confirmed to alleviate acute pain after video-assisted thoracoscopic surgery (VATS). In contrast, little is known about the effects of these methods on chronic post-surgical pain (CPSP). Aim: To investigate the effects of epidural block, paravertebral block, and intercostal nerve block on postoperative chronic pain in patients undergoing VATS. Material and methods: A total of 240 patients undergoing VATS were randomly divided into 4 groups: an epidural group, paravertebral group, intercostal group, and a control group. All patients were interviewed after 1, 3, 6, and 12 months to investigate the incidence and severity of CPSP. Results: The epidural group had lower incidence of chronic pain within 6 months and it was less severe within 3 months compared with the control group. The incidence and intensity of chronic pain within 3 months were lower in the intercostal group than in the control group. The incidence and intensity of pain within 1 month of surgery were lower in the paravertebral group than in the control group. Of the 122 patients who developed pain after 1 month, 93 (76.2%) reported chronic pain after 12 months, and only 9 (11.7%) had chronic pain after 12 months despite reporting no pain at 1 month. Conclusions: The prevalence of CPSP after VATS is high. Epidural block, paravertebral block, and intercostal nerve block can all reduce the incidence and severity of CPSP, with epidural block showing the best effect. In addition to acute pain, 1-month postoperative pain also exerts a warning effect on CPSP.

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The Effect of Preoperative Ultrasound-Guided Erector Spinae Plane Block on Chronic Postsurgical Pain After Breast Cancer Surgery: A Propensity Score-Matched Cohort Study

Cited by 7 publications

References 40 publications

Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery

Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery

Comparing ultrasound-guided serratus anterior plane block with erector spinae plane block for postoperative analgesia in thoracic and breast surgery: A systematic review and meta-analysis

The effects of different analgesic methods on chronic pain in patients undergoing video-assisted thoracoscopic surgery.

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