Perioperative pain management in thoracic surgery: A survey of practices in Australia and New Zealand.

IF 1.1 4区 医学 Q3 ANESTHESIOLOGY Anaesthesia and Intensive Care Pub Date : 2023-09-01 DOI:10.1177/0310057X231172787
Michael J Busser, Shakeel M Kunju, Usha Gurunathan
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引用次数: 1

Abstract

There are few data on current trends in pain management for thoracic surgery in Australia and New Zealand. Several new regional analgesia techniques have been introduced for these operations in the past few years. Our survey aimed to assess current practice and perceptions towards various modalities of pain management for thoracic surgery among anaesthetists in Australia and New Zealand. A 22-question electronic survey was developed and distributed in 2020 with the assistance of the Australian and New Zealand College of Anaesthetists Cardiac Thoracic Vascular and Perfusion Special Interest Group. The survey focused on four key domains-demographics, general pain management, operative technique, and postoperative approach. Of the 696 invitations, 165 complete responses were obtained, for a response rate of 24%. Most respondents reported a trend away from the historical standard of thoracic epidural analgesia, with a preference towards non-neuraxial regional analgesia techniques. If representative of anaesthetists in Australia and New Zealand more widely, this trend may result in less exposure of junior anaesthetists to the insertion and management of thoracic epidurals, potentially resulting in reduced familiarity and confidence in the technique. Furthermore, it demonstrates a notable reliance on surgically or intraoperatively placed paravertebral catheters as the primary analgesic modality, and suggests the need for future studies assessing the optimal method of catheter insertion and perioperative management. It also gives some insight into the current opinion and practice of the respondents with regard to formalised enhanced recovery after surgery pathways, acute pain services, opioid-free anaesthesia, and current medication selection.

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胸外科围手术期疼痛管理:澳大利亚和新西兰的实践调查。
关于澳大利亚和新西兰胸外科手术疼痛管理的当前趋势的数据很少。在过去的几年里,一些新的局部镇痛技术被引入到这些手术中。我们的调查旨在评估澳大利亚和新西兰麻醉师在胸外科手术中对各种疼痛管理方式的当前实践和看法。在澳大利亚和新西兰麻醉师学院心脏胸廓血管和灌注特别兴趣小组的协助下,于2020年开发并分发了一份包含22个问题的电子调查。调查集中在四个关键领域:人口统计学、一般疼痛管理、手术技术和术后入路。在696份邀请中,获得了165份完整回复,回复率为24%。大多数应答者报告了远离胸椎硬膜外镇痛的历史标准的趋势,倾向于非神经轴区域镇痛技术。如果澳大利亚和新西兰麻醉师的代表性更广泛,这一趋势可能导致初级麻醉师接触胸硬膜外置入和管理的机会减少,可能导致对该技术的熟悉程度和信心降低。此外,该研究表明手术或术中置入椎旁导管是主要的镇痛方式,并提示需要进一步研究评估导管置入和围手术期管理的最佳方法。它还提供了一些见解,目前的意见和做法,有关正式加强术后恢复途径,急性疼痛服务,无阿片类麻醉,和当前的药物选择的受访者。
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来源期刊
CiteScore
2.70
自引率
13.30%
发文量
150
审稿时长
3 months
期刊介绍: Anaesthesia and Intensive Care is an international journal publishing timely, peer reviewed articles that have educational value and scientific merit for clinicians and researchers associated with anaesthesia, intensive care medicine, and pain medicine.
期刊最新文献
Experiences and outcomes of patients participating in a perioperative shared decision-making pathway. JG Farrell and The Lung: An early description of intensive care delirium in literature. Promoting behavioural change by educating anaesthetists about the environmental impact of inhalational anaesthetic agents: A systematic review. MET call prevention. A cross-sectional study of the relationship between iron deficiency anaemia and chronic pain.
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