Incidence of Acute and Chronic Post-Thoracotomy Pain in Pediatric Patients

Marchetti, Giuliano; Vittori, Alessandro; Ferrari, Fabio; Francia, Elisa; Mascilini, Ilaria; Petrucci, Emiliano; Piga, Simone; Pardi, Valerio; Cascella, Marco; Contini, Giorgia; Marinangeli, Franco; Inserra, Alessandro; Picardo, Sergio

doi:10.3390/children8080642

Cited by 12 publications

(26 citation statements)

References 32 publications

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“…Currently, nerve block has become an alternative option for postoperative multi-modal analgesia and some forms of chronic pain treatment (2,3,23). Based on the current number of published nerve block articles, the overall research trend has been increasing from 1990 to the present.…”

Section: Abstract and Research Trendsmentioning

confidence: 99%

The global publication trend and research development of nerve block: A visualisation analysis between 1997 and 2021

Dong

Zhao

et al. 2022

Preprint

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Background: Nerve block is a clinical technique for relieving pain during surgery as well as for postoperative analgesia and chronic pain. Here, we analysed the trends in nerve block research and compared the contributions from different countries, institutions, journals, and authors. Methods: We extracted all studies concerning nerve block published between 1997 and 2021 from the Web of Science database. Microsoft Excel and VOSviewer were used to collect publication data, analyse publication trends, and visualize relevant results. Results: A total of 6,437 publications with 111,612 citations were identified between 1997 and 2021. The United States contributed the greatest number of publications (2010), whereas China ranked second (518). Regional Anesthesia & Pain Medicine had published the most papers concerning nerve block. Harvard University and Mariano ER were the most productive institution and author, respectively, in the field. Keywords were categorized into five clusters: the association between nerve block and anaesthesia or analgesia, local anaesthetic drugs for nerve block, nerve block techniques, nerve block for postoperative analgesia, and nerve block for oral local anaesthesia. Management-related research was a heavily researched topic in the field. Conclusions: We concluded that the United States contributed the most studies, and developing countries, led by China, are also encouraging study in this area. The exploration of new drugs in the fields of nerve block, multi-modal analgesia after surgery, treatment of chronic pain, analgesia for thoracic and abdominal surgeries, and analgesic interventions in oral therapy are a potential focus for future research.

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Section: Abstract and Research Trendsmentioning

confidence: 99%

The global publication trend and research development of nerve block: A visualisation analysis between 1997 and 2021

Dong

Zhao

et al. 2022

Preprint

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“…For instance, in a cross-sectional study from Italy it was shown that during the immediate post thoracotomy period 37.5% of children had at least one painful episode. 19 Post thoracotomy pain can result in a number of deleterious respiratory complications such as atelectasis, pneumonia and hypoxia. 18 Hence, optimal analgesia with frequent follow up by means of several clinical parameters and pain scoring should be a routine practice in these patients.…”

Section: Introductionmentioning

confidence: 99%

Thoracotomy in Children: Review from a Low-Income Country

Gebreselassie¹,

Tadesse²,

Woldeselassie³

2023

PHMT

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Background: Thoracotomy is indicated for several congenital and acquired disorders in children. It is among the surgical procedures which require a well-trained and dedicated surgical, anesthesia and critical care team which can be difficult to assemble in a lowincome country setup. As the pattern and outcome of thoracotomy in children remained unreported from such setting, this study aims to shed light on this matter. Methodology: A descriptive cross-sectional review was conducted. Children who have undergone thoracotomy for non-cardiac pathologies were included in the study. Demographic and clinical data were collected by chart review. Frequencies and percentages were used to describe categorical variables while mean, median, standard deviation and interquartile range were calculated for continuous variables. Results: A total of 68 patients were operated on in the study period, out of which 44 (64.7%) were males. The mean ages of the children at the time of diagnosis and procedure were 4.05 ± 3.9 years and 4.14 ± 4.03 years, respectively. The most common indication for thoracotomy was pulmonary hydatid cyst (17; 25%) followed by congenital lobar emphysema (11; 16.2%). Muscle sparing posterolateral thoracotomy was the most common approach in 66 (97.1%) patients. The analgesic medications that were used in the post-operative period were paracetamol, diclofenac, ibuprofen, tramadol and morphine. Combined analgesics were administered in two-thirds of the patients while a single analgesic was used in the rest of the children. No regional blocks were administered post operatively as pediatric size catheters were not available. The morbidity and mortality rates were found to be 11.8% and 8.8%, respectively. Conclusion:The most common indication for thoracotomy in this study was pulmonary hydatid cyst. The provision of postthoracotomy analgesia in our institution is suboptimal as evidenced by no use of regional blocks and poor practice of administering multimodal analgesia. Thoracotomy was associated with fairly high morbidity and mortality.

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“…Minimally invasive closure of transthoracic VSD was proven safe with excellent rates of closure [ 1 , 3 ]. Although this surgery procedure leaves a small puncture on the anterior chest wall, postoperative pain management remains a challenge in paediatric patients [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Transversus Thoracis Muscle Plane Block in Paediatric Patients Who Underwent Minimally Invasive Closure of Transthoracic Ventricular Septal Defect: A Retrospective Study

Ling

Zhao

Shi

et al. 2023

Pain Research and Management

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Objective. Minimally invasive closure of transthoracic ventricular septal defect (VSD) has been widely used in paediatric patients. This retrospective study aimed to explore the use of transversus thoracis muscle plane block (TTMPB) in the minimally invasive closure of transthoracic VSD in paediatric patients. Methods. From September 28, 2017, to July 25, 2022, a total of 119 paediatric patients scheduled for minimally invasive transthoracic VSD closure were considered for inclusion. Results. In total, 110 patients were included in the final analysis. Perioperative fentanyl consumption of the TTMPB group was not different from that of the non-TTMPB group (5.90 ± 1.32 μg/kg vs. 6.25 ± 1.74 μg/kg, p = 0.473). Both the time to extubation and postanesthesia care unit (PACU) stay were significantly shorter in the TTMPB group than in the non-TTMPB group (10.94 ± 10.31 min vs. 35.03 ± 23.52 min for extubation, and 42.55 ± 16.83 min vs. 59.98 ± 27.94 min for PACU stay, both p < 0.001). Furthermore, the postoperative paediatric intensive care unit (PICU) stay in the TTMPB group was significantly shorter than in the non-TTMPB group (1.04 ± 0.28 d vs. 1.34 ± 1.05 d, p = 0.005). Multivariate analysis demonstrated that TTMPB was significantly associated with shorter time to extubation ( p < 0.001) and PACU stay ( p = 0.001) but not postoperative PICU stay ( p = 0.094). Discussion. This study showed that TTMPB was a beneficial and safe regional anaesthesia technique for paediatric patients who underwent minimally invasive closure of transthoracic VSD, although prospective randomized controlled trials are needed to confirm the results.

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Incidence of Acute and Chronic Post-Thoracotomy Pain in Pediatric Patients

Cited by 12 publications

References 32 publications

The global publication trend and research development of nerve block: A visualisation analysis between 1997 and 2021

The global publication trend and research development of nerve block: A visualisation analysis between 1997 and 2021

Thoracotomy in Children: Review from a Low-Income Country

Transversus Thoracis Muscle Plane Block in Paediatric Patients Who Underwent Minimally Invasive Closure of Transthoracic Ventricular Septal Defect: A Retrospective Study

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