Analgesic drugs for patients with non-small cell lung cancer undergoing video-assisted thoracic surgery lobectomy: A randomized controlled trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIN Lin , JI Yanli ,  CHE Guowei , NIU Lingli , WANG Mingming , LI Xia , LIAO Hu , YANG Mei

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

CHE Guowei, Email: guowei_che@yahoo.com

Keywords：

Video-assisted thoracic surgery (VATS) lobectomy; parecoxib sodium; dezocine; lung cancer

DOI：

10.7507/1007-4848.201702021

Video：

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Objective To clearly define and describe the difference of analgesic actions and side effects between dezocine and parecoxib sodium in video-assisted thoracic surgery (VATS) lobectomy. Methods Ninety patients underwent thoracotomy (lobectomy) and were hospitalized in the Department of Thoracic Surgery, West China Hospital, Sichuan University between August 2015 and January 2016. Patients were randomly divided into two groups including a parecoxib sodium group (a PG group, 43 patients) and a dezocine group (a DG group, 47 patients). We analyzed the occurrence of side effects in the two groups, as well as other outcomes including visual analogous scores and location of the pain et al. Results The occurrences of nausea, vomit and abdominal distention in the PG group (9.30%, 2.33%, 13.95%) were significantly lower than those of the DG group (25.53%, 17.02%, 40.43% , P=0.046, P=0.032, P=0.009) in the early period after operation. Pain scores at the postoperative 12 h, 24 h, 48 h and 72 h in the PG group (2.56±0.96, 2.47±0.96, 1.93±0.99, 0.98±1.24) were better than those of the DG group (4.00±1.60, 3.62±1.48, 3.36±1.55, 2.47±1.78,P=0.000, P=0.000, P=0.000, P=0.002). And the same results were found in the postoperative coughing VAS assessment. The mostly reported pain location was the chest drainage, incision site and chest wall in turn. Postoperative pain properties, in turn, were swelling, stabbing pain and numbness. Conclusion Postoperative pain after VATS lobectomy may be adequately controlled using parecoxib sodium. The low pain scores and decreased adverse effects are achieved.

Citation： LIN Lin, JI Yanli, CHE Guowei, NIU Lingli, WANG Mingming, LI Xia, LIAO Hu, YANG Mei. Analgesic drugs for patients with non-small cell lung cancer undergoing video-assisted thoracic surgery lobectomy: A randomized controlled trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(11): 830-834. doi: 10.7507/1007-4848.201702021 Copy

1.	车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
2.	Yang HC, Lee JY, Ahn S, et al.Pain control of thoracoscopic major pulmonary resection: is pre-emptive local bupivacaine injection able to replace the intravenous patient controlled analgesia? J Thorac Dis, 2015, 7(11): 1960-1969.
3.	Tsubokawa N, Harada H, Takenaka C, et al.Comparison of postoperative pain after different thoracic surgery approaches as measured by electrical dtimulation. Thorac Cardiovasc Surg, 2015, 63(6): 519-525.
4.	Akter F, Routledge T, Toufektzian L, et al.In minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery? Interact Cardiovasc Thorac Surg, 2015,20(4): 550-555.
5.	Liu L, Che G, Pu Q, et al.A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy.Surg Oncol, 2010, 19(2): 71-77.
6.	Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 12(1):3165-3181.
7.	韩兆杰, 宋志芳, 苏建华, 等. 单胸腔引流管在肺癌术后快速康复中的应用. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
8.	杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后 16F 较 28F 胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
9.	周洪霞, 杨梅, 廖虎, 等. 胸腔镜肺叶切除术后 16F 尿管胸腔引流可行性的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 334-340.
10.	鲍珊, 苏建华, 廖虎, 等. 合并慢性阻塞性肺病和手术方式对肺癌患者术后快速康复及治疗费用的影响. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
11.	McElnay PJ, Molyneux M, Krishnadas R, et al. Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study. Eur J Cardiothorac Surg, 2015, 47(5): 912-915.
12.	Du N, Rao Z, Che G, et al.What is result: short-term medium chain triglyceride diet effective on postoperative outcome in lung cancer surgery? A prospective randomized study. Zhongguo Fei Ai Za Zh. 2016, 19(12):821-826.
13.	Kol E, Erdogan A, Karslı B. Nature and intensity of the pain following thoracotomy. Int J Nurs Pract. 2012, 18(1):84-90.
14.	Xu Y, Zhu Y, Wang S, et al.Dezocine attenuates fentanyl-induced cough in a dose-dependent manner-a randomized controlled trial. Int J Clin Exp Med. 2015, 8(4): 6091-6096.
15.	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.
16.	苏建华, 周渝斌, 蒲强, 等. 影响肺癌手术住院费用和快速康复的临床因素分析. 中国肺癌杂志, 2014, 17(7): 536-540.
17.	Cohen RI, Edwards WT, Kezer EA, et al. Serial intravenous doses of dezocine, morphine, and nalbuphine in the management of postoperative pain for outpatients. Anesth Analg, 1993, 77(3): 533-539.
18.	Fletcher D, Fermanian C, Mardaye A, et al. A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges. Pain. 2008, 137:441-451.
19.	Chen H, Luo A. Safety and efficacy study of the cyclooxygenase-2 inhibitor parecoxib sodium applied for postoperative analgesia after endo-nasal operation. Pain Pract, 2016, 16(4): 467-472.
20.	Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010, 13(11): 999-1003.

1. 车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
2. Yang HC, Lee JY, Ahn S, et al.Pain control of thoracoscopic major pulmonary resection: is pre-emptive local bupivacaine injection able to replace the intravenous patient controlled analgesia? J Thorac Dis, 2015, 7(11): 1960-1969.
3. Tsubokawa N, Harada H, Takenaka C, et al.Comparison of postoperative pain after different thoracic surgery approaches as measured by electrical dtimulation. Thorac Cardiovasc Surg, 2015, 63(6): 519-525.
4. Akter F, Routledge T, Toufektzian L, et al.In minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery? Interact Cardiovasc Thorac Surg, 2015,20(4): 550-555.
5. Liu L, Che G, Pu Q, et al.A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy.Surg Oncol, 2010, 19(2): 71-77.
6. Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 12(1):3165-3181.
7. 韩兆杰, 宋志芳, 苏建华, 等. 单胸腔引流管在肺癌术后快速康复中的应用. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
8. 杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后 16F 较 28F 胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
9. 周洪霞, 杨梅, 廖虎, 等. 胸腔镜肺叶切除术后 16F 尿管胸腔引流可行性的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 334-340.
10. 鲍珊, 苏建华, 廖虎, 等. 合并慢性阻塞性肺病和手术方式对肺癌患者术后快速康复及治疗费用的影响. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
11. McElnay PJ, Molyneux M, Krishnadas R, et al. Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study. Eur J Cardiothorac Surg, 2015, 47(5): 912-915.
12. Du N, Rao Z, Che G, et al.What is result: short-term medium chain triglyceride diet effective on postoperative outcome in lung cancer surgery? A prospective randomized study. Zhongguo Fei Ai Za Zh. 2016, 19(12):821-826.
13. Kol E, Erdogan A, Karslı B. Nature and intensity of the pain following thoracotomy. Int J Nurs Pract. 2012, 18(1):84-90.
14. Xu Y, Zhu Y, Wang S, et al.Dezocine attenuates fentanyl-induced cough in a dose-dependent manner-a randomized controlled trial. Int J Clin Exp Med. 2015, 8(4): 6091-6096.
15. 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.
16. 苏建华, 周渝斌, 蒲强, 等. 影响肺癌手术住院费用和快速康复的临床因素分析. 中国肺癌杂志, 2014, 17(7): 536-540.
17. Cohen RI, Edwards WT, Kezer EA, et al. Serial intravenous doses of dezocine, morphine, and nalbuphine in the management of postoperative pain for outpatients. Anesth Analg, 1993, 77(3): 533-539.
18. Fletcher D, Fermanian C, Mardaye A, et al. A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges. Pain. 2008, 137:441-451.
19. Chen H, Luo A. Safety and efficacy study of the cyclooxygenase-2 inhibitor parecoxib sodium applied for postoperative analgesia after endo-nasal operation. Pain Pract, 2016, 16(4): 467-472.
20. Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010, 13(11): 999-1003.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analgesic drugs for patients with non-small cell lung cancer undergoing video-assisted thoracic surgery lobectomy: A randomized controlled trial

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