Correlation Between Pain Intensity and Quality of Recovery After Video-Assisted Thoracic Surgery for Lung Cancer Resection

Yoon, Soo-Hyuk; Bae, Jinyoung; Yoon, Susie; Na, Kwon Joong; Lee, Ho-Jin

doi:10.2147/jpr.s426570

Cited by 8 publications

(3 citation statements)

References 31 publications

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“…This improvement was likely due to pain relief rather than an opioid-sparing effect. In our previous study in patients undergoing VATS, the aspect with the most potential for improvement among the QoR-15K items was the one related to postoperative pain, and postoperative pain intensity showed a significant correlation with the quality of recovery as assessed by the QoR-15K [ 29 ]. Therefore, it is likely that the reduction in pain due to the additional administration of the combined acetaminophen/ibuprofen formulation contributed significantly to enhancing the overall quality of postoperative recovery, rather than its opioid-sparing effect.…”

Section: Discussionmentioning

confidence: 99%

Effect of an intravenous acetaminophen/ibuprofen fixed-dose combination on postoperative opioid consumption and pain after video-assisted thoracic surgery: a double-blind randomized controlled trial

Lee,

Choi,

Yoon

et al. 2024

Surg Endosc

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Background Video-assisted thoracoscopic surgery (VATS) often induces significant postoperative pain, potentially leading to chronic pain and decreased quality of life. This study aimed to evaluate the acetaminophen/ibuprofen combination effectiveness in reducing analgesic requirements and pain intensity in patients undergoing VATS. Study design This is a double-blinded randomized controlled trial. Methods Adult patients scheduled for elective VATS for lung resection were randomized to receive either intravenous acetaminophen and ibuprofen (intervention group) or 100 mL normal saline (control group). Treatments were administered post-anesthesia induction and every 6 h for three cycles. The primary outcome was total analgesic consumption at 24 h postoperatively. Secondary outcomes were cumulative analgesic consumption at 2 and 48 h; analgesic-related side effects at 2, 24, and 48 h; quality of recovery at 24 h and 48 h postoperatively; pain intensity at rest and during coughing; and rescue analgesics use. Chronic postsurgical pain (CPSP) was assessed through telephone interviews 3 months postoperatively. Results The study included 96 participants. The intervention group showed significantly lower analgesic consumption at 24 h and 48 h postoperatively (24 h: median difference: − 100 µg equivalent intravenous fentanyl [95% confidence interval (CI) − 200 to − 5 μg], P = 0.037; 48 h: median difference: − 140 μg [95% CI − 320 to − 20 μg], P = 0.035). Compared to the controls, the intervention group exhibited a significantly lower quality of recovery 24 h post-surgery, with no significant difference at 48 h. All pain scores except for coughing at 48 h post-surgery were significantly lower in the intervention group compared to the controls. No significant differences were observed between the groups in postoperative nausea and vomiting occurrence, hospital stay length, and CPSP. Conclusion Perioperative administration of acetaminophen/ibuprofen significantly decreased analgesic needs in patients undergoing VATS, providing an effective postoperative pain management strategy, and potentially minimizing the need for stronger analgesics.

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Section: Discussionmentioning

confidence: 99%

Effect of an intravenous acetaminophen/ibuprofen fixed-dose combination on postoperative opioid consumption and pain after video-assisted thoracic surgery: a double-blind randomized controlled trial

Lee,

Choi,

Yoon

et al. 2024

Surg Endosc

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“…This score is calculated from a questionnaire, in which patients use a grading system from 0-10 to answer fifteen questions regarding their postoperative recovery. 18 The score, designed to provide a multifaceted assessment of a patients postoperative recovery, is a validated means of assessing quality of patient recovery after surgery and is now recommended as an endpoint in clinical trials focused on the assessment of postoperative pain. 19…”

Section: Study Outcomes Primary Outcomementioning

confidence: 99%

A comparison of efficacy of erector spinae plane block versus serratus anterior plane block plus subcostal transversus abdominus plane block for bariatric laparoscopic sleeve gastrectomy surgery: study protocol for a randomised clinical trial.

Wiseman,

Walt,

O'Riordan

et al. 2024

Preprint

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Background Obesity is a rapidly growing global health concern. Limited long-term success of diet, behavioural modification and medical therapy have led to the increased performance of bariatric surgery. Laparoscopic sleeve gastrectomy, which permanently reduces the size of the stomach, has been shown to cause considerable weight loss, as well as improving or even eliminating obesity related medical comorbidities such as diabetes, obstructive sleep apnoea and hypertension. Unfortunately, this surgery can also result in significant postoperative pain which, when combined with the dangers of perioperative opioid administration for bariatric patients, can lead to a significantly reduced quality of recovery. Opioid-sparing analgesia has been widely recommended for perioperative bariatric patients but research into the optimum regional analgesia approach for this surgery is lacking, with no trials to date comparing different regional analgesic techniques. This study protocol describes a randomised clinical trial aimed at answering this question, comparing the quality of recovery after laparoscopic sleeve gastrectomy for patients who receive erector spinae plane block, versus those who receive serratus anterior plane block plus subcostal TAP block. Methods We propose a prospective, randomised, blinded (investigator) clinical trial in a tertiary hospital in Ireland. 70 patients presenting for laparoscopic sleeve gastrectomy will be randomised to two study groups – group A will receive bilateral erector spinae blockade, group B will receive left sided serratus anterior plane block plus subcostal TAP blocks. Both groups will receive the same dose of the same local anaesthetic and the different regional technique performed will be the only difference in their care. The primary outcome will be QoR-15 scores at 24 hours postoperatively, a validated international tool for assessing a patient’s overall postoperative recovery. Discussion Regional analgesia should be a mainstay of perioperative opioid-sparing analgesia where possible. This is especially important in the bariatric cohort who are particularly susceptible to the complications of perioperative opioid administration. To the best of our knowledge, this trial will be the first to compare efficacy of two different regional analgesia techniques for bariatric patients undergoing laparoscopic sleeve gastrectomy surgery. Trial Registration This trial was pre-registered on clinicaltrials.gov, reference number NCT05839704, on March 5th 2023. All items from the World Health Organisation Trial Registration Data Set have been included.

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“…The effective control of postoperative pain is an important part of perioperative care and significantly influences the process of postoperative recovery [ 1 , 2 ]. Inadequate postoperative pain control causes discomfort to the patient, thereby reducing satisfaction [ 3 ] and greatly impedes functional recovery after surgery.…”

Section: Introductionmentioning

confidence: 99%

Beyond measurement: a deep dive into the commonly used pain scales for postoperative pain assessment

Choi,

Yoon,

Lee

2024

Korean J Pain

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This review explores the essential methodologies for effective postoperative pain management, focusing on the need for thorough pain assessment tools, as underscored in various existing guidelines. Herein, the strengths and weaknesses of commonly used pain scales for postoperative pain-the Visual Analog Scale, Numeric Rating Scale, Verbal Rating Scale, and Faces Pain Scale-are evaluated, highlighting the importance of selecting appropriate assessment tools based on factors influencing their effectiveness in surgical contexts. By emphasizing the need to comprehend the minimal clinically important difference (MCID) for these scales in evaluating new analgesic interventions and monitoring pain trajectories over time, this review advocates recognizing the limitations of common pain scales to improve pain assessment strategies, ultimately enhancing postoperative pain management. Finally, five recommendations for pain assessment in research on postoperative pain are provided: first, selecting an appropriate pain scale tailored to the patient group, considering the strengths and weaknesses of each scale; second, simultaneously assessing the intensity of postoperative pain at rest and during movement; third, conducting evaluations at specific time points and monitoring trends over time; fourth, extending the focus beyond the intensity of postoperative pain to include its impact on postoperative functional recovery; and lastly, interpreting the findings while considering the MCID, ensuring that it is clinically significant for the chosen pain scale. These recommendations broaden our understanding of postoperative pain and provide insights that contribute to more effective pain management strategies, thereby enhancing patient care outcomes.

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Correlation Between Pain Intensity and Quality of Recovery After Video-Assisted Thoracic Surgery for Lung Cancer Resection

Cited by 8 publications

References 31 publications

Effect of an intravenous acetaminophen/ibuprofen fixed-dose combination on postoperative opioid consumption and pain after video-assisted thoracic surgery: a double-blind randomized controlled trial

Effect of an intravenous acetaminophen/ibuprofen fixed-dose combination on postoperative opioid consumption and pain after video-assisted thoracic surgery: a double-blind randomized controlled trial

A comparison of efficacy of erector spinae plane block versus serratus anterior plane block plus subcostal transversus abdominus plane block for bariatric laparoscopic sleeve gastrectomy surgery: study protocol for a randomised clinical trial.

Beyond measurement: a deep dive into the commonly used pain scales for postoperative pain assessment

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