{"title":"不同区域镇痛方法对胸外科手术后慢性疼痛的影响。","authors":"Korgün Ökmen, Şule Balk, Gamze Gözen Güvenç","doi":"10.5114/kitp.2023.134175","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Chronic postsurgical pain (CPSP) is defined as pain persisting for ≥ 3 months after surgery, severely impairing patients' long-term daily activities and quality of life.</p><p><strong>Aim: </strong>To evaluate the effects of various regional analgesia methods, including thoracic epidural (TE), serratus anterior plane (SAP) block, rhomboid intercostal block (RIB) and paravertebral block (PVB), on the incidence of chronic post-thoracic surgery pain.</p><p><strong>Material and methods: </strong>A total of 489 patients (240 thoracotomy, 249 VATS) were included in the analysis. The primary outcome measure was the VAS score (postoperative 6<sup>th</sup> month), while the secondary outcome measures were the LANSS score (postoperative 6<sup>th</sup> month), the use of analgesic medication and descriptive information.</p><p><strong>Results: </strong>In thoracotomy patients, VAS scores were statistically significantly lower in patients who underwent RIB and SAP block compared to those who underwent TE and patient-controlled anesthesia (PCA). LANSS scores did not differ between the RIB, SAP and TE groups, while higher scores were found in the PCA group. After VATS, VAS scores were statistically significantly lower in patients who underwent RIB, SAP and PVB block compared to the PCA group. LANSS scores were statistically significantly lower in the RIB and SAP block groups than in the PVB and PCA groups.</p><p><strong>Conclusions: </strong>This study found that patients who received regional anesthesia had lower LANSS scores and VAS values, indicative of neuropathic pain reduction, following thoracotomy and VATS procedures.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 4","pages":"233-239"},"PeriodicalIF":0.6000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10809817/pdf/","citationCount":"0","resultStr":"{\"title\":\"The effect of different regional analgesia methods on chronic pain after thoracic surgery.\",\"authors\":\"Korgün Ökmen, Şule Balk, Gamze Gözen Güvenç\",\"doi\":\"10.5114/kitp.2023.134175\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Chronic postsurgical pain (CPSP) is defined as pain persisting for ≥ 3 months after surgery, severely impairing patients' long-term daily activities and quality of life.</p><p><strong>Aim: </strong>To evaluate the effects of various regional analgesia methods, including thoracic epidural (TE), serratus anterior plane (SAP) block, rhomboid intercostal block (RIB) and paravertebral block (PVB), on the incidence of chronic post-thoracic surgery pain.</p><p><strong>Material and methods: </strong>A total of 489 patients (240 thoracotomy, 249 VATS) were included in the analysis. The primary outcome measure was the VAS score (postoperative 6<sup>th</sup> month), while the secondary outcome measures were the LANSS score (postoperative 6<sup>th</sup> month), the use of analgesic medication and descriptive information.</p><p><strong>Results: </strong>In thoracotomy patients, VAS scores were statistically significantly lower in patients who underwent RIB and SAP block compared to those who underwent TE and patient-controlled anesthesia (PCA). LANSS scores did not differ between the RIB, SAP and TE groups, while higher scores were found in the PCA group. After VATS, VAS scores were statistically significantly lower in patients who underwent RIB, SAP and PVB block compared to the PCA group. 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引用次数: 0
摘要
简介:慢性手术后疼痛(CPSP)是指手术后疼痛持续≥3 个月,严重影响患者的长期日常活动和生活质量:目的:评估包括胸硬膜外(TE)、前锯肌平面(SAP)阻滞、斜方肌肋间阻滞(RIB)和椎旁阻滞(PVB)在内的各种区域镇痛方法对胸外科术后慢性疼痛发生率的影响:共有 489 例患者(240 例开胸术,249 例 VATS)被纳入分析。主要结果指标为VAS评分(术后第6个月),次要结果指标为LANSS评分(术后第6个月)、镇痛药物使用情况和描述性信息:在胸廓切开术患者中,与接受 TE 和患者控制麻醉 (PCA) 的患者相比,接受 RIB 和 SAP 阻滞的患者的 VAS 评分在统计学上明显较低。RIB、SAP和TE组的LANSS评分没有差异,而PCA组的评分较高。VATS 后,与 PCA 组相比,接受 RIB、SAP 和 PVB 阻滞的患者的 VAS 评分在统计学上明显较低。RIB和SAP阻滞组的LANSS评分在统计学上明显低于PVB和PCA组:本研究发现,接受区域麻醉的患者在胸廓切开术和 VATS 手术后的 LANSS 评分和 VAS 值较低,表明神经性疼痛减轻。
The effect of different regional analgesia methods on chronic pain after thoracic surgery.
Introduction: Chronic postsurgical pain (CPSP) is defined as pain persisting for ≥ 3 months after surgery, severely impairing patients' long-term daily activities and quality of life.
Aim: To evaluate the effects of various regional analgesia methods, including thoracic epidural (TE), serratus anterior plane (SAP) block, rhomboid intercostal block (RIB) and paravertebral block (PVB), on the incidence of chronic post-thoracic surgery pain.
Material and methods: A total of 489 patients (240 thoracotomy, 249 VATS) were included in the analysis. The primary outcome measure was the VAS score (postoperative 6th month), while the secondary outcome measures were the LANSS score (postoperative 6th month), the use of analgesic medication and descriptive information.
Results: In thoracotomy patients, VAS scores were statistically significantly lower in patients who underwent RIB and SAP block compared to those who underwent TE and patient-controlled anesthesia (PCA). LANSS scores did not differ between the RIB, SAP and TE groups, while higher scores were found in the PCA group. After VATS, VAS scores were statistically significantly lower in patients who underwent RIB, SAP and PVB block compared to the PCA group. LANSS scores were statistically significantly lower in the RIB and SAP block groups than in the PVB and PCA groups.
Conclusions: This study found that patients who received regional anesthesia had lower LANSS scores and VAS values, indicative of neuropathic pain reduction, following thoracotomy and VATS procedures.
期刊介绍:
Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.