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：

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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. 电视胸腔镜与开胸手术治疗复发性自发性气胸的疗效观察. 中国胸心血管外科临床杂志, 2009, 16(2): 153-155.
2.	Senturk M. Acute and chronic pain after thoracotomies. Curr Opin Anaesthesiol, 2005, 18(1) : 1-4.
3.	黎介寿, 吴孟超, 主编. 胸外科手术学, 第 2 版. 北京: 人民军医出版社, 2004. 250.
4.	张志庸, 主编. 协和胸外科学, 第 2 版. 北京: 科学出版社, 2010. 291.
5.	韦兵, 何建行, 杨运有, 等. 电视胸腔镜手术治疗自发性气胸的临床研究. 广东医学, 2002, 23(6): 586-587.
6.	李小刚, 童华, 周荣胜, 等. 帕瑞昔布对胸腔镜肺叶切除术围术期疼痛和炎性细胞因子的影响. 西安交通大学学报(医学版), 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.	刘恫林, 丁伟, 主编. 胸部疾病电视胸腔镜诊断治疗学. 天津: 天津科技翻译出版公司, 2001. 53.
10.	张志庸, 主编. 现代胸外科治疗方法, 第 1 版. 北京: 中国协和医科大学出版社, 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, 段红兵, 康健乐, 等. 改良肋间神经冷冻术在胸部术后镇痛中应用的随机对照研究. 中国胸心血管外科临床杂志, 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.	夏宏伟, 方秦模, 牛庆玲, 等. 罗哌卡因肋间神经阻滞用于开胸术后镇痛效果观察. 中国社区医师. 2015, 31(14): 36-37.
16.	秦建军, 赵松, 赵高峰, 等. 开胸术后冷冻肋间神经镇痛的临床研究. 中国胸心血管外科临床杂志, 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.	崔凯, 王晓东, 张涛, 等. 开胸术后患者静脉自控镇痛联合与不联合肋间神经冷冻效果比较. 陕西医学杂志, 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.	车国卫, 李为民, 刘伦旭. 快速肺康复需要围手术期流程优化. 中国胸心血管外科临床杂志, 2016, 23(3): 216-220.
21.	王天佑. 快速康复外科理念与胸外科. 中国胸心血管外科临床杂志, 2014, 21(1): 3-4.

1. 彭俊, 毛新, 王平, 等. 电视胸腔镜与开胸手术治疗复发性自发性气胸的疗效观察. 中国胸心血管外科临床杂志, 2009, 16(2): 153-155.
2. Senturk M. Acute and chronic pain after thoracotomies. Curr Opin Anaesthesiol, 2005, 18(1) : 1-4.
3. 黎介寿, 吴孟超, 主编. 胸外科手术学, 第 2 版. 北京: 人民军医出版社, 2004. 250.
4. 张志庸, 主编. 协和胸外科学, 第 2 版. 北京: 科学出版社, 2010. 291.
5. 韦兵, 何建行, 杨运有, 等. 电视胸腔镜手术治疗自发性气胸的临床研究. 广东医学, 2002, 23(6): 586-587.
6. 李小刚, 童华, 周荣胜, 等. 帕瑞昔布对胸腔镜肺叶切除术围术期疼痛和炎性细胞因子的影响. 西安交通大学学报(医学版), 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. 刘恫林, 丁伟, 主编. 胸部疾病电视胸腔镜诊断治疗学. 天津: 天津科技翻译出版公司, 2001. 53.
10. 张志庸, 主编. 现代胸外科治疗方法, 第 1 版. 北京: 中国协和医科大学出版社, 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, 段红兵, 康健乐, 等. 改良肋间神经冷冻术在胸部术后镇痛中应用的随机对照研究. 中国胸心血管外科临床杂志, 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. 夏宏伟, 方秦模, 牛庆玲, 等. 罗哌卡因肋间神经阻滞用于开胸术后镇痛效果观察. 中国社区医师. 2015, 31(14): 36-37.
16. 秦建军, 赵松, 赵高峰, 等. 开胸术后冷冻肋间神经镇痛的临床研究. 中国胸心血管外科临床杂志, 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. 崔凯, 王晓东, 张涛, 等. 开胸术后患者静脉自控镇痛联合与不联合肋间神经冷冻效果比较. 陕西医学杂志, 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. 车国卫, 李为民, 刘伦旭. 快速肺康复需要围手术期流程优化. 中国胸心血管外科临床杂志, 2016, 23(3): 216-220.
21. 王天佑. 快速康复外科理念与胸外科. 中国胸心血管外科临床杂志, 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

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