Department of Thoracic Surgery, Ichikawa Hospital, International University of Health and Welfare, Ichikawa, Japan.
Ann Palliat Med. 2022 Apr;11(4):1191-1196. doi: 10.21037/apm-21-1756. Epub 2021 Nov 25.
Video-assisted thoracoscopic surgery (VATS) has been established as a standard therapeutic approach for pneumothorax; however, patients may experience pronounced pain during the postoperative period, and the optimization of analgesic approaches during the postoperative period is necessary. The aim of this study was to determine for the first time the effect of a physical therapist-guided exercise program on pain perception and analgesic use in the postoperative period after VATS for spontaneous pneumothorax.
This retrospective study included 73 patients aged ≤40 years (mean age is 21, range is 15 to 40) with spontaneous pneumothorax treated with VATS that were divided in exercise-based rehabilitation (n=23) and no rehabilitation (n=50) groups. Postoperative pain perception and the use of analgesics were investigated in patients who did or did not undergo an aerobic exercise postoperatively.
In patients who underwent an exercise-based postoperative rehabilitation program, the pain control was more effective, the numeric rating scale (NRS) (25.46/42.31, P=0.02), and the dose of analgetic medication was lower than the patients who undergo rehabilitation (P=0.008).
Overall, our findings suggest for the first time that exercise-based postoperative rehabilitation may be a viable option for pain reduction after VATS for spontaneous pneumothorax in young adults.
电视辅助胸腔镜手术（VATS）已被确立为气胸的标准治疗方法；然而，患者在术后可能会经历明显的疼痛，因此需要优化术后的镇痛方法。本研究的目的是首次确定物理治疗师指导的锻炼计划对 VATS 治疗自发性气胸后患者术后疼痛感知和镇痛药物使用的影响。
本回顾性研究纳入了 73 名年龄≤40 岁（平均年龄为 21 岁，范围为 15 岁至 40 岁）的自发性气胸患者，这些患者均接受 VATS 治疗，并分为进行基于运动的康复治疗组（n=23）和未进行康复治疗组（n=50）。对术后是否进行有氧运动的患者进行术后疼痛感知和镇痛药物使用的调查。
在接受基于运动的术后康复治疗的患者中，疼痛控制效果更明显，数字评分量表（NRS）（25.46/42.31，P=0.02）和镇痛药剂量均低于未接受康复治疗的患者（P=0.008）。
总的来说，我们的研究结果首次表明，基于运动的术后康复可能是减轻年轻成人 VATS 治疗自发性气胸后疼痛的可行选择。
