Kang Do Kyun, Kang Min Kyun
Department of Thoracic and Cardiovascular Surgery, College of Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea.
Ann Thorac Med. 2022 Jul-Sep;17(3):180-183. doi: 10.4103/atm.atm_128_22. Epub 2022 Jul 9.
Uniportal thoracoscopic surgery has been reported to result in alleviating the postoperative pain when compared with traditional video-assisted thoracoscopic surgery (VATS). However, postoperative pain is still the main concerns associated with thoracic surgeries. The objective of this study is to evaluate the postoperative pain of patients undergoing uniportal VATS, especially wedge resection, with the use of intraoperative intercostal nerve block.
All consecutive patients undergoing the uniportal VATS wedge resection between January 2019 and March 2020 were reviewed retrospectively. Twenty consecutive patients in Group A underwent the uniportal VATS wedge resection without intraoperative intercostal nerve block. The other 20 consecutive patients in Group B underwent the uniportal VATS wedge resection with intraoperative intercostal nerve block. The numeric pain rating scale (NRS) scores were recorded at 1, 12, and 24 h, postoperatively. The number of opioid consumption was also recorded until the time to chest tube removal.
There was no difference between groups with regard to sex, age, chest tube duration, length of stay, operative time, laterality time, and diagnosis. There was a significant difference in postoperative NRS scores at 1 h ( = 0.001) and 12 h ( = 0.022) between the groups. The opioid consumption was significantly in Group B lower than those in Group A ( = 0.025).
The intraoperative intercostal nerve block with bupivacaine provided immediate postoperative pain relief with reducing the postoperative opioid consumption compared in patients who underwent uniportal VATS, especially wedge resection of the lung.
据报道,与传统电视辅助胸腔镜手术(VATS)相比,单孔胸腔镜手术可减轻术后疼痛。然而,术后疼痛仍是胸外科手术的主要关注点。本研究的目的是评估接受单孔VATS手术,尤其是楔形切除术的患者,术中使用肋间神经阻滞时的术后疼痛情况。
回顾性分析2019年1月至2020年3月期间所有连续接受单孔VATS楔形切除术的患者。A组连续20例患者接受单孔VATS楔形切除术,术中未进行肋间神经阻滞。B组连续20例患者接受单孔VATS楔形切除术,术中进行肋间神经阻滞。术后1、12和24小时记录数字疼痛评分量表(NRS)得分。同时记录直至拔除胸管时的阿片类药物消耗量。
两组在性别、年龄、胸管留置时间、住院时间、手术时间、侧别时间和诊断方面无差异。两组术后1小时(P = 0.001)和12小时(P = 0.022)的NRS得分存在显著差异。B组的阿片类药物消耗量显著低于A组(P = 0.025)。
与接受单孔VATS手术,尤其是肺楔形切除术的患者相比,术中使用布比卡因进行肋间神经阻滞可立即缓解术后疼痛,并减少术后阿片类药物的消耗量。