scholarly journals Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Deng ◽  
Xiao-min Hou ◽  
Xu-yan Zhou ◽  
Qing-he Zhou
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Video Assisted ◽  
Prospective Randomized Controlled Trial ◽  
Numerical Rating ◽  
Intercostal Block ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after video-assisted thoracoscopic surgery (VATS). This prospective randomized controlled trial was performed to analyze the postoperative analgesic effects of ultrasound-guided RIB block and RISS block after video-assisted thoracoscopic surgery. Methods Ninety patients aged between 18 and 80 years, with American Society of Anesthesiologists physical status Classes I–II and scheduled for elective unilateral VATS were randomly allocated into three groups. In group C, no block intervention was performed. Patients in group RIB received ultrasound-guided RIB with 20-mL 0.375% ropivacaine and those in group RISS received ultrasound-guided RIB and serratus plane block using a total of 40-mL 0.375% ropivacaine. All patients received intravenous sufentanil patient-controlled analgesia upon arrival in the recovery room. Postoperative sufentanil consumption and pain scores were compared among the groups. Results The dosages of sufentanil consumption at 24 h after the surgery in the RIB and RISS groups were significantly lower than that in group C (p < 0.001 and p < 0.001 for all comparisons, respectively), the postoperative Numerical Rating Scale (NRS) scores in the RIB and RISS groups at 0.5, 1, 3, 6, 12, 18, and 24 h after surgery when patients were at rest or active were significantly lower than that in group C (p < 0.05 for all comparisons). The required dosage of sufentanil and time to first postoperative analgesic request in groupRISS were less than those in the group RIB at 24 h after the surgery (p < 0.001 and p < 0.001 for all comparisons, respectively). Similarly, the Numerical Rating Scale scores for group RISS at 12, 18, and 24 h after the surgery when the patients were active were significantly lower than those for group RIB (p < 0.05 for all comparisons). Conclusion Both ultrasound-guided RIB block and RISS block can effectively reduce the demand for sufentanil within 24 h after VATS, and less sufentanil dosage is needed in patient with RISS block. Ultrasound-guided RIB block and RISS block can effectively relieve pain within 24 h after VATS, and RISS block is more effective.

scholarly journals Comparison of the analgesic effect of ultrasound-guided paravertebral block and ultrasound-guided retrolaminar block in Uniportal video-assisted Thoracoscopic surgery: a prospective, randomized study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiang Wang ◽  
Shijing Wei ◽  
Shuai Li ◽  
Jie Yu ◽  
Guohua Zhang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Adverse Events ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Thoracoscopic Surgery ◽  
Randomized Study ◽  
Paravertebral Block ◽  
Ultrasound Guided ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background The optimal modality for postoperative analgesia after uniportal video-assisted thoracoscopic surgery (UVATS) for the treatment of lung cancer has not yet been determined. Both ultrasound-guided paravertebral block (PVB) and retrolaminar block (RLB) have been reported to be successful in providing analgesia after UVATS. However, which block technique provides superior analgesia after UVATS is still unclear. This randomized study was designed to compare the postoperative analgesic effects and adverse events associated with ultrasound-guided PVB and RLB after UVATS. Methods Sixty patients with lung cancer were randomized to undergo ultrasound-guided PVB (group P) or ultrasound-guided RLB (group R). In group P, 30 mL of 0.5% ropivacaine was injected at the T3 and T5 levels via ultrasound-guided PVB (15 mL at each level on the operative side). In group R, 30 mL of 0.5% ropivacaine was injected at the T3 and T5 levels via ultrasound-guided RLB (15 mL at each level on the operative side). The primary outcome was the numerical rating scale (NRS) score within 48 h after surgery. The secondary outcomes were total postoperative sufentanil consumption, time to first analgesic request and adverse events. Results At 3, 6, 12, 24, 36 and 48 h postoperatively, the NRS score at rest in group P was lower than that in group R (p < 0.05). At 3, 6, 12, 24 and 36 h postoperatively, the NRS score while coughing in group P was lower than that in group R (p < 0.05). The total postoperative sufentanil consumption in group P was significantly lower than that in group R (p < 0.001). Additionally, the time to first analgesic request was longer in group R than in group P (p < 0.0001). The incidence of nausea in group R was higher than that in group P (p < 0.05). Conclusions In patients with lung cancer undergoing UVATS, ultrasound-guided PVB with 0.5% ropivacaine provides better analgesia and results in less nausea than ultrasound-guided RLB. Compared with ultrasound-guided RLB, ultrasound-guided PVB seems to be a better technique for analgesia in UVATS. Trial registration The name of this study is the Effect And Mechanism Of Ultrasound-guided Multimodal Regional Nerve Block On Acute And Chronic Pain After Thoracic Surgery. This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100044060). The date of registration was March 9, 2021.

scholarly journals Evaluation of Rhomboid Intercostal Block in Video-assisted Thoracic Surgery: Comparing three Concentrations of Ropivacaine

2021 ◽  
Author(s):  
Fen Liu ◽  
Wei Deng ◽  
Qing-he Zhou ◽  
Chen-Wei Jiang
Keyword(s):  
Rating Scales ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Psychological Support ◽  
Control Group ◽  
Ultrasound Guided ◽  
Video Assisted ◽  
Physical Comfort ◽  
Double Blinded ◽  
Intercostal Block

Abstract Background: Ultrasound-guided rhombic intercostal block (RIB) is a novel regional block that provides analgesia for patients who have received video-assisted thoracoscopic surgery (VATS). The anesthetic characteristics of ultrasound-guided RIB with different concentrations of ropivacaine are not known. This research primarily hypothesizes that ultrasound-guided RIB, given in combination with the same volume of different concentrations of ropivacaine, would improve the whole quality of recovery-40 (QoR-40) among patients with VATS.Approaches: This double-blinded, single-center, prospective, and controlled trial randomized 100 patients undergoing VATS to receive RIB. One hundred patients who have received elective VATS and satisfied inclusion standards were fallen into four groups randomly: control group with no RIB and R0.2%, R0.3%, and R0.4%; they underwent common anesthesia plus the RIB with ropivacaine at 0.2%, 0.3%, and 0.4% in a volume of 30mL.Outcomes: Groups R0.2%, R0.3%, and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the control group (Group C) (p<0.001 for all contrasts). Group R0.3% and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the R0.2% group (p<0.001 for all contrasts). The overall QoR-40 scores and QoR-40 dimensions (physical comfort [p=0.585]) did not vary greatly between the Group R0.3% and R0.4% (p>0.05 for all contrasts). Group R0.2%, R0.3% and R0.4% showed significant differences in numerical rating scales (NRS) score region under the curve (AUC) at rest and on movement in 48 hours when compared with the Group C (p<0.001 for all contrasts). Group R0.3% and R0.4% displayed great diversities in NRS score AUC at rest and on movement in 48 hours when compared with the R0.2% group (p<0.001 for all contrasts). The NRS mark AUC at rest and on movement in 48 hours did not vary greatly between the Group R0.3% and R0.4% (p>0.05 for all contrasts).Conclusion: It was found that a dose of 0.3% ropivacaine is the best concentration for RIB for patients undergoing VATS. Through growing ropivacaine concentration, the analgesia of the RIB was not improved greatly.Trial registration number: ChiCTR2100046254

scholarly journals Evaluation of Rhomboid Intercostal Block in Video-Assisted Thoracic Surgery: Comparing Three Concentrations of Ropivacaine

2022 ◽  
Vol 12 ◽  
Author(s):  
Wei Deng ◽  
Chen-Wei Jiang ◽  
Ke-jian Qian ◽  
Fen Liu
Keyword(s):  
Rating Scales ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Psychological Support ◽  
Control Group ◽  
Ultrasound Guided ◽  
Video Assisted ◽  
Physical Comfort ◽  
Double Blinded ◽  
Intercostal Block

Background: Ultrasound-guided rhombic intercostal block (RIB) is a novel regional block that provides analgesia for patients who have received video-assisted thoracoscopic surgery (VATS). The anesthetic characteristics of ultrasound-guided RIB with different concentrations of ropivacaine are not known. This research primarily hypothesizes that ultrasound-guided RIB, given in combination with the same volume of different concentrations of ropivacaine, would improve the whole quality of recovery-40 (QoR-40) among patients with VATS.Approaches: This double-blinded, single-center, prospective, and controlled trial randomized 100 patients undergoing VATS to receive RIB. One hundred patients who have received elective VATS and satisfied inclusion standards were fallen into four groups randomly: control group with no RIB and R0.2%, R0.3%, and R0.4%; they underwent common anesthesia plus the RIB with ropivacaine at 0.2%, 0.3%, and 0.4% in a volume of 30 ml.Outcomes: Groups R0.2%, R0.3%, and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the control group (Group C) (p &lt; 0.001 for all contrasts). Groups R0.3% and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the R0.2% group (p &lt; 0.001 for all contrasts). The overall QoR-40 scores and QoR-40 dimensions [physical comfort (p = 0.585)] did not vary greatly between Groups R0.3% and R0.4% (p &gt; 0.05 for all contrasts). Groups R0.2%, R0.3%, and R0.4% showed significant differences in numerical rating scales (NRS) score region under the curve (AUC) at rest and on movement in 48 h when compared with the Group C (p &lt; 0.001 for all contrasts). Groups R0.3% and R0.4% displayed great diversities in NRS score AUC at rest and on movement in 48 h when compared with the R0.2% group (p &lt; 0.001 for all contrasts). The NRS mark AUC at rest and, on movement in 48 h, did not vary greatly between the Group R0.3% and R0.4% (p &gt; 0.05 for all contrasts).Conclusion: In this study it was found that a dose of 0.3% ropivacaine is the best concentration for RIB for patients undergoing VATS. Through growing ropivacaine concentration, the analgesia of the RIB was not improved greatly.Clinicaltrials.gov Registration:https://clinicaltrials.gov/, identifier ChiCTR2100046254.

scholarly journals A Prospective Study of Chronic Pain after Thoracic Surgery

2017 ◽  
Vol 126 (5) ◽  
pp. 938-951 ◽  
Author(s):  
Emine Ozgur Bayman ◽  
Kalpaj R. Parekh ◽  
John Keech ◽  
Atakan Selte ◽  
Timothy J. Brennan
Keyword(s):  
Chronic Pain ◽  
Thoracic Surgery ◽  
Rating Scale ◽  
Comprehensive Evaluation ◽  
Numerical Rating Scale ◽  
Thoracoscopic Surgery ◽  
Numerical Rating ◽  
A Prospective Study ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background The goal of this study was to detect the predictors of chronic pain at 6 months after thoracic surgery from a comprehensive evaluation of demographic, psychosocial, and surgical factors. Methods Thoracic surgery patients were enrolled 1 week before surgery and followed up 6 months postsurgery in this prospective, observational study. Comprehensive psychosocial measurements were assessed before surgery. The presence and severity of pain were assessed at 3 and 6 months after surgery. One hundred seven patients were assessed during the first 3 days after surgery, and 99 (30 thoracotomy and 69 video-assisted thoracoscopic surgery, thoracoscopy) patients completed the 6-month follow-up. Patients with versus without chronic pain related to thoracic surgery at 6 months were compared. Results Both incidence (P = 0.37) and severity (P = 0.97) of surgery-related chronic pain at 6 months were similar after thoracotomy (33%; 95% CI, 17 to 53%; 3.3 ± 2.1) and thoracoscopy (25%; 95% CI, 15 to 36%; 3.3 ± 1.7). Both frequentist and Bayesian multivariate models revealed that the severity of acute pain (numerical rating scale, 0 to 10) is the measure associated with chronic pain related to thoracic surgery. Psychosocial factors and quantitative sensory testing were not predictive. Conclusions There was no difference in the incidence and severity of chronic pain at 6 months in patients undergoing thoracotomy versus thoracoscopy. Unlike other postsurgical pain conditions, none of the preoperative psychosocial measurements were associated with chronic pain after thoracic surgery.

932 A Systematic Review and Meta-Analysis of Subxiphoid Versus Unilateral Intercostal Video-Assisted Thoracoscopic Surgery

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
D Patel ◽  
A Almukhtar ◽  
E Caruana
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Thoracoscopic Surgery ◽  
Meta Analysis ◽  
Intraoperative Complications ◽  
Length Of Hospital Stay ◽  
Operative Duration ◽  
Video Assisted ◽  
Subxiphoid Approach ◽  
Video Assisted Thoracoscopic Surgery

Abstract Introduction Subxiphoid approach is emerging as an alternative to intercostal video-assisted thoracoscopic surgery (VATS). We sought to compare the clinical efficacy of both approaches. Method A protocol was registered at PROSPERO [CRD42020155686]. Studies were retrieved from literature in July 2020. The Main outcomes were operative duration, intraoperative complications and postoperative length of hospital stay (LoS). Subgroup analysis was performed by procedure type. Results 1469 patients (51% male) were included from 12 observational studies, with 620 (42%) having undergone sVATS. There was a high-moderate risk of bias across included papers. There was no difference in operative duration (MD 13.1 minutes, 95% CI -11.3 to + 37.6; p = 0.29), intraoperative complications (OR 0.17, 95% CI -0.28 to + 0.61; p = 0.47), or LoS (MD -0.8 days, 95% CI -1.8 to + 0.2; p = 0.08). LoS was lower for sVATS thymectomy (MD -1.7 days, 95% CI -2.9 to -0.3; p = 0.01). Acute pain (10-point numerical rating scale) was lower for sVATS (MD -2.2, 95% CI -3.2 to -1.2; p &lt; 0.001). There was insufficient data to report on chronic pain, quality of life, or surgeon workload. Conclusions There is a potential benefit for sVATS in selected procedures. Well-designed randomised trials with consistent outcome reporting are required.

scholarly journals A randomised controlled trial of peri-operative pregabalin vs. placebo for video-assisted thoracoscopic surgery

Anaesthesia ◽  
2015 ◽  
Vol 71 (2) ◽  
pp. 192-197 ◽  
Author(s):  
A. H. Konstantatos ◽  
W. Howard ◽  
D. Story ◽  
L. Y. H. Mok ◽  
D. Boyd ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Video Assisted ◽  
Randomised Controlled ◽  
Video Assisted Thoracoscopic Surgery
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