Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery
Xiaoning Zhao, Xiaoqian Li, Ying Wang, Weijie Xiao, Baihui Zhang, Xin Meng, Xijia Sun The Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, People’s Republic of ChinaCorrespondence: Xijia Sun, The Department of Anesthesiology, The First Affiliated Hos...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-08-01
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| Series: | Journal of Pain Research |
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| Online Access: | https://www.dovepress.com/efficacy-of-intrathoracic-intercostal-nerve-block-on-postoperative-acu-peer-reviewed-fulltext-article-JPR |
| _version_ | 1798041196021415936 |
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| author | Zhao X Li X Wang Y Xiao W Zhang B Meng X Sun X |
| author_facet | Zhao X Li X Wang Y Xiao W Zhang B Meng X Sun X |
| author_sort | Zhao X |
| collection | DOAJ |
| description | Xiaoning Zhao, Xiaoqian Li, Ying Wang, Weijie Xiao, Baihui Zhang, Xin Meng, Xijia Sun The Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, People’s Republic of ChinaCorrespondence: Xijia Sun, The Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, People’s Republic of China, Tel +86 15840015620, Email xijia0822@163.comBackground: Patients undergoing video-assisted thoracoscopic surgery (VATS) frequently suffered postoperative acute and chronic pains. In recent years, intrathoracic intercostal nerve block (INB) is regularly used thanks to its safety and accuracy, especially under the circumstance of lacking ultrasound or in face of the contraindications of the thoracic paravertebral block (TPVB). However, clinical evidence of comparing TPVB and INB for pain management after VATS has been limited and the observation of the chronic pain has been less than clear.Methods: A total of 180 patients undergoing VATS were randomly divided into three groups: A single multi-point paravertebral nerve block (Group P), intrathoracic intercostal nerve block (Group I), and general anesthesia without any regional block (Group C). Postoperative acute pain was scored at rest and coughing by the Visual Analog Scale (VAS) for recording 24h, 48h and 72h after VATS. All patients were interviewed 1, 3 and 6 months after the surgery to investigate both the incidence and intensity of chronic pains.Results: There were significantly less incidence and intensity of acute pain in Group P and Group I, compared to those in Group C. The patients in Group I showed the least incidence and intensity of chronic pain after 3 months compared with those in Group P and Group C. There are 89 of 98 patients suffering pains after 1 month, which grew into chronic pains after 3 months and 78 of them still suffered chronic pains even after 6 months.Conclusion: The intrathoracic INB offers excellent relief from acute and chronic pains, which does as effectively as TPVB. Besides, one-month postoperative pain could increase the risk of a chronic one.Keywords: video-assisted thoracoscopic surgery, acute pain, chronic pain, intrathoracic intercostal nerve block, paravertebral nerve block |
| first_indexed | 2024-04-11T22:18:07Z |
| format | Article |
| id | doaj.art-44f869f610c74cc7aba0066f3e36f2ef |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-04-11T22:18:07Z |
| publishDate | 2022-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-44f869f610c74cc7aba0066f3e36f2ef2022-12-22T04:00:19ZengDove Medical PressJournal of Pain Research1178-70902022-08-01Volume 152273228177168Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic SurgeryZhao XLi XWang YXiao WZhang BMeng XSun XXiaoning Zhao, Xiaoqian Li, Ying Wang, Weijie Xiao, Baihui Zhang, Xin Meng, Xijia Sun The Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, People’s Republic of ChinaCorrespondence: Xijia Sun, The Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, People’s Republic of China, Tel +86 15840015620, Email xijia0822@163.comBackground: Patients undergoing video-assisted thoracoscopic surgery (VATS) frequently suffered postoperative acute and chronic pains. In recent years, intrathoracic intercostal nerve block (INB) is regularly used thanks to its safety and accuracy, especially under the circumstance of lacking ultrasound or in face of the contraindications of the thoracic paravertebral block (TPVB). However, clinical evidence of comparing TPVB and INB for pain management after VATS has been limited and the observation of the chronic pain has been less than clear.Methods: A total of 180 patients undergoing VATS were randomly divided into three groups: A single multi-point paravertebral nerve block (Group P), intrathoracic intercostal nerve block (Group I), and general anesthesia without any regional block (Group C). Postoperative acute pain was scored at rest and coughing by the Visual Analog Scale (VAS) for recording 24h, 48h and 72h after VATS. All patients were interviewed 1, 3 and 6 months after the surgery to investigate both the incidence and intensity of chronic pains.Results: There were significantly less incidence and intensity of acute pain in Group P and Group I, compared to those in Group C. The patients in Group I showed the least incidence and intensity of chronic pain after 3 months compared with those in Group P and Group C. There are 89 of 98 patients suffering pains after 1 month, which grew into chronic pains after 3 months and 78 of them still suffered chronic pains even after 6 months.Conclusion: The intrathoracic INB offers excellent relief from acute and chronic pains, which does as effectively as TPVB. Besides, one-month postoperative pain could increase the risk of a chronic one.Keywords: video-assisted thoracoscopic surgery, acute pain, chronic pain, intrathoracic intercostal nerve block, paravertebral nerve blockhttps://www.dovepress.com/efficacy-of-intrathoracic-intercostal-nerve-block-on-postoperative-acu-peer-reviewed-fulltext-article-JPRvideo-assisted thoracoscopic surgeryacute painchronic painintrathoracic intercostal nerve blockparavertebral nerve block |
| spellingShingle | Zhao X Li X Wang Y Xiao W Zhang B Meng X Sun X Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery Journal of Pain Research video-assisted thoracoscopic surgery acute pain chronic pain intrathoracic intercostal nerve block paravertebral nerve block |
| title | Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery |
| title_full | Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery |
| title_fullStr | Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery |
| title_full_unstemmed | Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery |
| title_short | Efficacy of Intrathoracic Intercostal Nerve Block on Postoperative Acute and Chronic Pains of Patients Undergoing Video-Assisted Thoracoscopic Surgery |
| title_sort | efficacy of intrathoracic intercostal nerve block on postoperative acute and chronic pains of patients undergoing video assisted thoracoscopic surgery |
| topic | video-assisted thoracoscopic surgery acute pain chronic pain intrathoracic intercostal nerve block paravertebral nerve block |
| url | https://www.dovepress.com/efficacy-of-intrathoracic-intercostal-nerve-block-on-postoperative-acu-peer-reviewed-fulltext-article-JPR |
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