胸外科手术后疼痛：结合硬膜外镇痛重新评估电视辅助胸腔镜手术的益处。
Postoperative pain in thoracic surgery: re-evaluating the benefits of VATS when coupled with epidural analgesia.
作者信息
Obuchi Toshiro, Yoshida Yasuhiro, Moroga Toshihiko, Miyahara Naofumi, Iwasaki Akinori
机构信息
Department of Thoracic Surgery, St. Mary's Hospital, Kurume, Japan.
Department of Thoracic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
出版信息
J Thorac Dis. 2017 Nov;9(11):4347-4352. doi: 10.21037/jtd.2017.09.133.
BACKGROUND
In order to evaluate the reduced postoperative pain of complete video-assisted thoracoscopic surgery (cVATS), a study was conducted to compare acute postoperative pain between cVATS and open thoracotomy employing continuous epidural analgesia (EA).
METHODS
A total of 62 patients, 49 males and 13 females with a mean age of 54.8 years, who had undergone thoracic surgery at our institution from November 2013 to June 2015 were enrolled in this study. We statistically investigated differences in the intensity of postoperative pain between cVATS with or without EA and between cVATS and open thoracotomy under EA. The degree of pain was measured using a visual analog scale, nine times for three days after the surgery.
RESULTS
The mean postoperative pain scores were stronger in the cVATS without EA group than in the group treated with EA at every single observation point, although there were no significant differences. When employing EA, no significant differences were found between cVATS and open thoracotomy.
CONCLUSIONS
The use of EA may overshadow the benefits of using cVATS over open thoracotomy.
背景
为了评估全胸腔镜手术（cVATS）术后疼痛减轻的情况，进行了一项研究，比较cVATS与采用连续硬膜外镇痛（EA）的开胸手术术后的急性疼痛。
方法
本研究纳入了2013年11月至2015年6月在我院接受胸外科手术的62例患者，其中男性49例，女性13例，平均年龄54.8岁。我们对有无EA的cVATS之间以及EA下cVATS与开胸手术之间术后疼痛强度的差异进行了统计学研究。使用视觉模拟量表测量疼痛程度，术后三天测量九次。
结果
在每个观察点，无EA的cVATS组术后平均疼痛评分均高于EA治疗组，尽管差异无统计学意义。采用EA时，cVATS与开胸手术之间未发现显著差异。
结论
使用EA可能会掩盖cVATS相对于开胸手术的优势。
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