Outcome of fast track surgery after intercostal nerve block during thoracoscopic resection of lung bullae: A randomized controlled trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Dan ^1,2 , QU Xinming ¹ , QIN Wei ¹ ,  GAO Ke ³

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. First Department of Surgery, The Traditional Chinese Medicine Hospital, Anyue, 642350, Sichuan, P.R.China;
3. Department of Thoracic and Cardiovascular Surgery, The Second People's Hospital of Chengdu, Chengdu, 610017, P.R.China;

Corresponding?author：

GAO Ke, Email: dr.gaoke@hotmail.com

Keywords：

Intravenous patient-controlled analgesia; intercostal nerve block; thoracoscopic resection of lung bullae; pleurodesis; fast track surgery

DOI：

10.7507/1007-4848.201611034

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the outcome of fast track surgery after intercostal nerve block (INB) during thoracoscopic resection of lung bullae. Methods We recuited 76 patients who accepted thoracoscopic resection of lung bullae from February 2013 to March 2015. They were randomly divided into two groups: an intercostal nerve block and intravenous patient-controlled analgesia (INB+IPCA) group, in which 38 patients (30 males, 8 females, with a mean age of 23.63±4.10 years) received INB intraoperatively and IPCA postoperatively, and a postoperative intravenous patient-controlled analgesia (IPCA) group, in which 38 patients (33 males, 5 females, with a mean age of 24.93±6.34 years) only received IPCA postoperatively. Their general clinical data and the postoperative pain visual analogue scale (VAS) were recorded. Analgesia-associated side effects, rate of the pulmonary infection were observed. Expenses associated with analgesia during hospital were calculated. Results The score of VAS, the incidence of nausea and vomiting, fatigue and other side effects, pulmonary atelectasis and the infection rate in the INB+IPCA group were significantly lower than those in the IPCA group. Postoperative use of analgesic drugs was significantly less than that in the IPCA group. Medical expenses did not significantly increase. Conclusion INB+IPCA is beneficial for fast track surgery after thoracoscopic resection of lung bullae.

Citation： LIU Dan, QU Xinming, QIN Wei, GAO Ke. Outcome of fast track surgery after intercostal nerve block during thoracoscopic resection of lung bullae: A randomized controlled trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(9): 696-700. doi: 10.7507/1007-4848.201611034 Copy

1.	彭俊, 毛新, 王平, 等. 電視胸腔鏡與開胸手術治療復發性自發性氣胸的療效觀察. 中國胸心血管外科臨床雜志, 2009, 16(2): 153-155.
2.	Senturk M. Acute and chronic pain after thoracotomies. Curr Opin Anaesthesiol, 2005, 18(1) : 1-4.
3.	黎介壽, 吳孟超, 主編. 胸外科手術學, 第 2 版. 北京: 人民軍醫出版社, 2004. 250.
4.	張志庸, 主編. 協和胸外科學, 第 2 版. 北京: 科學出版社, 2010. 291.
5.	韋兵, 何建行, 楊運有, 等. 電視胸腔鏡手術治療自發性氣胸的臨床研究. 廣東醫學, 2002, 23(6): 586-587.
6.	李小剛, 童華, 周榮勝, 等. 帕瑞昔布對胸腔鏡肺葉切除術圍術期疼痛和炎性細胞因子的影響. 西安交通大學學報(醫學版), 2013, 34(5): 659-663.
7.	Havanagh BP, Katz J, Sandler AN. Pain control after thoracic Surgery. A review of current techniques. Anesthesiology, 1994, 81(3): 737-759.
8.	Rogers ML, Dufy JP. Surgical aspects of chronic post-thoracotomy pain. Eur J Cardiothorac Surg, 2000, 18(6): 711-716.
9.	劉恫林, 丁偉, 主編. 胸部疾病電視胸腔鏡診斷治療學. 天津: 天津科技翻譯出版公司, 2001. 53.
10.	張志庸, 主編. 現代胸外科治療方法, 第 1 版. 北京: 中國協和醫科大學出版社, 2004. 21.
11.	Moorjani N, Zhao F, Tian Y, et al. Efects of cryoanalgesia on post-thoracotomy pain and on the structure of intercostals nerves: a human prospective randomized trial and a histological study. Eur J Cardiothorac Surg, 2001, 20(3): 502-507.
12.	Miller LC, Salzer GM,Ransmayr G, et al.. Intraoperative cryoanalgesia for post-thoracotomy pain relief. Ann Thorac Surg, 1998; 48: 15-18.
13.	何建冰, 段紅兵, 康健樂, 等. 改良肋間神經冷凍術在胸部術后鎮痛中應用的隨機對照研究. 中國胸心血管外科臨床雜志, 2016, 23(1): 34-37.
14.	Moorthy SS, dierdorf SF, Yaw PB. Influence of volume on the spread of local anesthetic methylene blue solution after injection for intercostal block. Anesth Analg, 1992; 75: 389-391.
15.	夏宏偉, 方秦模, 牛慶玲, 等. 羅哌卡因肋間神經阻滯用于開胸術后鎮痛效果觀察. 中國社區醫師. 2015, 31(14): 36-37.
16.	秦建軍, 趙松, 趙高峰, 等. 開胸術后冷凍肋間神經鎮痛的臨床研究. 中國胸心血管外科臨床雜志, 2006, 23(2): 25-27.
17.	Faust RJ, Nauss LA. Post-thoracotomy intercostal block:comparison of its effects on pulmonary function with those of intramusscular meperidine. Anesth Analg, 1976, 55: 542-546.
18.	崔凱, 王曉東, 張濤, 等. 開胸術后患者靜脈自控鎮痛聯合與不聯合肋間神經冷凍效果比較. 陜西醫學雜志, 2015, 44(11): 1495-1496.
19.	Kotemane NC, Gopinath N, Vaja R. Analgesic techniques following thoracic surgery: A survey of United Kingdom practice. Eur J Anaesthesiol, 2010, 27(10): 897-899.
20.	車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.
21.	王天佑. 快速康復外科理念與胸外科. 中國胸心血管外科臨床雜志, 2014, 21(1): 3-4.

1. 彭俊, 毛新, 王平, 等. 電視胸腔鏡與開胸手術治療復發性自發性氣胸的療效觀察. 中國胸心血管外科臨床雜志, 2009, 16(2): 153-155.
2. Senturk M. Acute and chronic pain after thoracotomies. Curr Opin Anaesthesiol, 2005, 18(1) : 1-4.
3. 黎介壽, 吳孟超, 主編. 胸外科手術學, 第 2 版. 北京: 人民軍醫出版社, 2004. 250.
4. 張志庸, 主編. 協和胸外科學, 第 2 版. 北京: 科學出版社, 2010. 291.
5. 韋兵, 何建行, 楊運有, 等. 電視胸腔鏡手術治療自發性氣胸的臨床研究. 廣東醫學, 2002, 23(6): 586-587.
6. 李小剛, 童華, 周榮勝, 等. 帕瑞昔布對胸腔鏡肺葉切除術圍術期疼痛和炎性細胞因子的影響. 西安交通大學學報(醫學版), 2013, 34(5): 659-663.
7. Havanagh BP, Katz J, Sandler AN. Pain control after thoracic Surgery. A review of current techniques. Anesthesiology, 1994, 81(3): 737-759.
8. Rogers ML, Dufy JP. Surgical aspects of chronic post-thoracotomy pain. Eur J Cardiothorac Surg, 2000, 18(6): 711-716.
9. 劉恫林, 丁偉, 主編. 胸部疾病電視胸腔鏡診斷治療學. 天津: 天津科技翻譯出版公司, 2001. 53.
10. 張志庸, 主編. 現代胸外科治療方法, 第 1 版. 北京: 中國協和醫科大學出版社, 2004. 21.
11. Moorjani N, Zhao F, Tian Y, et al. Efects of cryoanalgesia on post-thoracotomy pain and on the structure of intercostals nerves: a human prospective randomized trial and a histological study. Eur J Cardiothorac Surg, 2001, 20(3): 502-507.
12. Miller LC, Salzer GM,Ransmayr G, et al.. Intraoperative cryoanalgesia for post-thoracotomy pain relief. Ann Thorac Surg, 1998; 48: 15-18.
13. 何建冰, 段紅兵, 康健樂, 等. 改良肋間神經冷凍術在胸部術后鎮痛中應用的隨機對照研究. 中國胸心血管外科臨床雜志, 2016, 23(1): 34-37.
14. Moorthy SS, dierdorf SF, Yaw PB. Influence of volume on the spread of local anesthetic methylene blue solution after injection for intercostal block. Anesth Analg, 1992; 75: 389-391.
15. 夏宏偉, 方秦模, 牛慶玲, 等. 羅哌卡因肋間神經阻滯用于開胸術后鎮痛效果觀察. 中國社區醫師. 2015, 31(14): 36-37.
16. 秦建軍, 趙松, 趙高峰, 等. 開胸術后冷凍肋間神經鎮痛的臨床研究. 中國胸心血管外科臨床雜志, 2006, 23(2): 25-27.
17. Faust RJ, Nauss LA. Post-thoracotomy intercostal block:comparison of its effects on pulmonary function with those of intramusscular meperidine. Anesth Analg, 1976, 55: 542-546.
18. 崔凱, 王曉東, 張濤, 等. 開胸術后患者靜脈自控鎮痛聯合與不聯合肋間神經冷凍效果比較. 陜西醫學雜志, 2015, 44(11): 1495-1496.
19. Kotemane NC, Gopinath N, Vaja R. Analgesic techniques following thoracic surgery: A survey of United Kingdom practice. Eur J Anaesthesiol, 2010, 27(10): 897-899.
20. 車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.
21. 王天佑. 快速康復外科理念與胸外科. 中國胸心血管外科臨床雜志, 2014, 21(1): 3-4.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Outcome of fast track surgery after intercostal nerve block during thoracoscopic resection of lung bullae: A randomized controlled trial

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content