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Management of acute postoperative pain with continuous intercostal nerve block after single port video-assisted thoracoscopic anatomic resection.

Abstract：

BACKGROUND:Effective postoperative pain control for thoracic surgery is very important, not only because it reduces pulmonary complications but also because it accelerates the pace of recovery. Moreover, it increases patients' satisfaction with the surgery. In this study, we present a simple approach involving the safe placement of intercostal catheter (ICC) after single port video-assisted thoracoscopic surgery (VATS) anatomic resection and we evaluate postoperative analgesic function with and without it. METHODS:We identified patients who underwent single port anatomic resection with ICC placed intraoperatively as a route for continuous postoperative levobupivacaine (0.5%) administration and retrospectively compared them with a group of single port anatomic resection patients without ICC. The operation time, postoperative day 0, 1, 2, 3 and discharge day pain score, triflow numbers, narcotic requirements, drainage duration and post-operative hospital stay were compared. RESULTS:In total, 78 patients were enrolled in the final analysis (39 patients with ICC and 39 without). We found patients with ICC had less pain sensation numerical rating scale (NRS) on postoperative day 0, 1 (P=0.023, <0.001) and better triflow performance on postoperative day 1 and 2 (P=0.015, 0.032). In addition, lower IV form morphine usage frequency and dosage (P=0.009, 0.017), shorter chest tube drainage duration (P=0.001) and postoperative stay (P=0.005) were observed in the ICC group. CONCLUSIONS:Continuous intercostal nerve blockade by placing an ICC intraoperatively provides effective analgesia for patients undergoing single port VATS anatomic resection. This may be considered a viable alternative for postoperative pain management.

journal_name

J Thorac Dis

journal_title

Journal of thoracic disease

authors

Hsieh MJ,Wang KC,Liu HP,Gonzalez-Rivas D,Wu CY,Liu YH,Wu YC,Chao YK,Wu CF

doi

10.21037/jtd.2016.12.30

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

3563-3571

issue

eissn

2072-1439

issn

2077-6624

pii

jtd-08-12-3563

journal_volume

pub_type

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Management of acute postoperative pain with continuous intercostal nerve block after single port video-assisted thoracoscopic anatomic resection.