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

Abstract

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.

Reliability and validity analyses of the postoperative comfort scale for patients with lung cancer undergoing endoscopic surgery and an evaluation of patient comfort

“…Following surgery, the patients would likely experience pain in the wound, accompanied by aggravated physiological discomfort induced by coughing and expectoration, dry mouth, thirst, catheter stimulation, etc., which was consistent with the research by Zhu et al [11]. As previously reported [17,18], thoracic surgery may produce the most severe pain among all surgical operations. After the surgery, when the patients have awoken, they undergo back tapping with coughing and expectoration.…”

Perioperative Transcutaneous Electrical Acupoint Stimulation Reduces Postoperative Pain in Patients Undergoing Thoracoscopic Surgery: A Randomized Controlled Trial

“…Poorly controlled acute pain after VATS also leads to chronic postsurgical pain, which can severely impair physical function and quality of life. Although there are some treatments for postoperative pain, such as paravertebral nerve block, thoracic epidural block, and intercostal nerve block, the postoperative pain in patients undergoing VATS remains at a high incidence (ranging from 59% to 90%) [ 8 , 16 ]. As traditional Chinese acupuncture therapy, TEAS is a noninvasive form of acupuncture interventions which applies electrical stimulation onto acupuncture points using transcutaneous electrodes.…”

The effect of different regional analgesia methods on chronic pain after thoracic surgery

“…In another study including patients who underwent TEA, PVB and intercostal nerve blockade, all three methods reduced the incidence and severity of CPSP. However, the most significant effect was found in the TEA group [ 25 ]. Literature data are insufficient on the effect of field blocks on CPSP after VATS.…”