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Comparison of the analgesic effects of continuous extrapleural block and continuous epidural block after video-assisted thoracoscopic surgery.

Abstract：

DESIGN:A prospective, randomized, open study. The regional technique used was not blinded. SETTING:A university teaching hospital. PARTICIPANTS:Forty-eight patients undergoing video-assisted thoracoscopic surgery (VATS) for tumor resection. INTERVENTIONS:Patients received either continuous extrapleural block or continuous epidural block using ropivacaine for a period of 60 hours after surgery. MEASUREMENTS AND MAIN RESULTS:To evaluate postoperative pain control, the primary and secondary endpoints were the visual analog scale (VAS) on movement and the amount of rescue analgesia, respectively. There were no significant differences between the extrapleural and epidural block groups with regard to VAS at rest and during movement assessed at 4, 12, 24, 36, and 48 hours after surgery, dosage of intravenous morphine (extrapleural: 12.9 ± 11.3, epidural: 10.2 ± 6.9 mg), supplemental nonsteroidal anti-inflammatory drugs, incidence of postoperative nausea and vomiting (extrapleural: 12/20, epidural: 11/20), postoperative ambulation (extrapleural: 18 at postoperative day [POD] 1 and 20 at POD 2, epidural: 19 at POD 1 and 20 at POD 2) and hospital stay after surgery (extrapleural: 12.7 ± 6.3, epidural: 12.6 ± 4.7 days). CONCLUSIONS:Although this study did not show the superiority of continuous extrapleural block relative to continuous epidural in VATS patients, the results suggest that both methods provided effective analgesia with a relatively small dose of rescue morphine. Although the analgesic effects of these techniques were comparable, extrapleural block has the advantage of safety and precise placement of the catheter and can be considered an alternative to epidural block in VATS patients.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Hotta K,Endo T,Taira K,Sata N,Inoue S,Takeuchi M,Seo N,Endo S

doi

10.1053/j.jvca.2011.07.026

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

1009-13

issue

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(11)00546-5

journal_volume

pub_type

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Comparison of the analgesic effects of continuous extrapleural block and continuous epidural block after video-assisted thoracoscopic surgery.