Moderate-severe postoperative pain in patients undergoing video-assisted thoracoscopic surgery: A retrospective study

Sun, Kai; Liu, Daiyun; Chen, Jie; Yu, Shui; Bai, Yongyu; Chen, Congcong; Yu, Yanbing; Lu, Yu; Yan, Min

doi:10.1038/s41598-020-57620-8

Cited by 60 publications

(49 citation statements)

References 26 publications

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“…Maybe smoking before the operation lead to a bad cough and the cough induced serious pain. Single-port VATS contributed to a lower incidence of severe pain compared with three-port VATS in our study, which was similar to previous results by Sun et al 16 Their results demonstrated that increased BMI, smoking history, and multi-port VATS had high incidence of moderate-severe pain during the first 24 hours after operation. There was another study which illustrated that besides pain intensity, the functional areas such as physical function, role function, emotional function, social function, and the overall health status of the patients with single-port were significantly better than those with three-port.…”

Section: Discussionsupporting

confidence: 92%

<p>Characteristics of Postoperative Pain After VATS and Pain-Related Factors: The Experience in National Cancer Center of China</p>

Tong¹,

Wei²,

Wang³

et al. 2020

JPR

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Purpose: No final conclusion has yet been reached on characteristics of postoperative pain and pain-related factors after video-assisted thoracoscopic surgery (VATS). This study was designed to explore features of acute severe pain and chronic post-surgical pain (CPSP), and the pain-related factors of VATS. Patients and Methods: Data of patients who underwent VATS for lung cancer in Cancer Hospital, Chinese Academy of Medical Sciences between March 2017 and January 2019 were reviewed in this retrospective study. A numerical rating scale (NRS) was used for evaluating the intensity of postoperative pain including no pain (NRS=0), mild pain (NRS=1-3), moderate pain (NRS=4-6), and severe pain (NRS=7-10). Pain intensity was assessed daily within a week after operation, and also evaluated at 3 months postoperatively. Results: One hundred and five (3.4%) of the 3072 patients enrolled experienced severe pain (NRS=7-10) on the 1st day after operation, and 17 (0.6%) on the 2nd day. Smoking history, three-port VATS, prolonged operation time, and without patient-controlled analgesia (PCA) were correlated to increased incidence of severe pain. Among all patients, 237 (7.7%) cases generated CPSP, and VATS type, operation time, duration of drainage, and severe pain on the 1st day were four independent risk factors related to CPSP. Conclusion: Patients seemed to experience a lower incidence of acute severe pain and CPSP after VATS than traditional open surgery. Acute severe pain was correlated with smoking history, VATS type, operation time, and PCA; VATS type, operation time, duration of drainage, and severe pain on the 1st day postoperatively were four independent risk factors of CPSP.

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Section: Discussionsupporting

confidence: 92%

<p>Characteristics of Postoperative Pain After VATS and Pain-Related Factors: The Experience in National Cancer Center of China</p>

Tong¹,

Wei²,

Wang³

et al. 2020

JPR

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“…Kullanılan trokar sayısının postoperatif sonuçlarının araştırıldığı torakoskopik palmar hiperhidrosis ameliyatlarında, daha az postoperatif pnömotoraks, hastanede kalış ve ameliyat sonrası toraks direni gerekliliğinin daha az olduğu rapor edilmiştir [7,20] . VATS sonrası ilk 48 saatte ağrı nedenlerinin araştırıldığı büyük serili, retrospektif bir çalışmada; hastaların %15.6'sında orta ve şiddetli ağrı geliştiği ve ağrıya neden olan etmenlerin genç yaş, yüksek vücut kitle indeksi, sigara kullanımı ve göğüs tüpü sayısının olduğu rapor edilmiştir [21] . Prospektif randomize kontrollü bir çalışmada, VATS sonrası toraks tüpü varlığının, postoperatif ağrının önemli nedenlerinden biri olduğu rapor edilmiş ve mümkün olan en kısa zamanda çekilmesi önerilmiştir [22] .…”

Section: Is Intravenous Morphine Alone Sufficiently Effective For Posunclassified

“…Bununla birlikte, cerrahi yaklaşım açısından minimal invaziv bir teknik olan torakoskopik girişimlerde, postoperatif ağrı için invaziv girişimlerin gerekliliği tartışılmaktadır [24] . Tek giriş ve plevra diseksiyonu yapılmadan klips ile gerçekleştirilen ve sonrasında toraks direni kullanılmayan torakoskopik sempatektomi ameliyatlarında ağrının şiddetinin daha az olması ve en azından daha kısa sürmesi beklenebilir [21] . Bu çalışmada da ITM uygulanan grupta postoperatif ağrı skorlarının düşük olduğu ve postoperatif 48 saat boyunca yalnızca eks-tübasyon sonrası erken dönemde ilave analjezik gereksinimlerinin olduğu gözlenmiştir.…”

Section: Is Intravenous Morphine Alone Sufficiently Effective For Posunclassified

“…Rejyonel girişimlerin, İV HKA ile karşılaştırıldığı bir diğer çalışmada, postoperatif 1. günde hastaların 25.8±11.6 mg/m 2 morfin gereksinimlerinin olduğu rapor edilmiştir [31] . Standart yön-temle yapılan torakoskopik ameliyat sonrası ilk 48 saatlik ağrının değerlendirildiği bir başka çalışmada da, 1. gün hastalar ortalama 45.8±13.5 mg İV morfin almalarına rağmen, orta ve şiddetli ağrı tanımlamışlardır [21] . Torakotomilere göre VATS uygulamalarının daha az ağrı oluşturmasının yanında, postoperatif yaşam kalitesi ve pulmoner komplikasyonları azalttığı ve hastanede kalış süresini kısalttığı bildirilmiştir [25,26] .…”

Section: Is Intravenous Morphine Alone Sufficiently Effective For Posunclassified

“…VATS lobektomi uygulanan hastalarda yapılan bir çalışmada, özellikle ilk 48 saatte hastaların %59'unda orta ve şiddetli ağrı rapor edilmiştir [3] . Buna benzer başka bir çalışmada, yine hastaların %15.6'sında postoperatif ilk 48 saat, ağrılarının fazla olduğu ve ameliyat sonrası yerleştirilen toraks tüpünün bu ağrıdan sorumlu olduğu bildirilmiştir [21] . İntratekal ve İV olarak verilen morfine bağlı yan etkiler ve görülme sıklıkları birçok çalışmada gösterilmiştir [32] .…”

Section: Is Intravenous Morphine Alone Sufficiently Effective For Posunclassified

See 2 more Smart Citations

Is Intravenous Morphine Alone Effective for Postoperative Analgesia in Bilateral, Single-port Video-Assisted Thoracoscopic Sympathectomy Performed in the Supine Position?

Uğuz¹,

Yapıcı²

2020

GKDA Derg

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INTRODUCTION: The method of operation carried out by clip application in the supine position and using a single port for thoracoscopic sympathectomy has been defined in recent years. Since lesser tissue damage occurs with this method, lower perception of pain may be anticipated. The aim of this study is to investigate whether intravenous morphine alone provides effective postoperative analgesia in thoracoscopic sympathectomy performed with clips method using a single port with the patient in the supine position. METHODS: Files of 28 patients who underwent thoracoscopic sympathectomy between January 2017-December 2019 were retrospectively screened. Intrathecal morphine was administered to a group at a dose of 0.6 mg in 3 mL physiologic saline (Group ITM, n=14), and the other group received IV morphine in the same doses only by the PCA method (Group PCA, n=14). Both groups received postoperative Patient Controlled Analgesia (PCA) with IV morphine, as 1 mg bolus within 30 min-lock- in time. VAS values and postoperative IV total morphine consumption were recorded at the time of extubation and at the 6th, 24th and 48th hours postoperatively RESULTS: Any statistically significant difference was not detected between patient groups as for demographic, and operative data. After extubation and at postoperative 6th hour, pain scores were statistically significantly lower in Group ITM than the Group PCA. Total IV morphine consumption at the postoperative 24th and 48th hours was statistically significant in the Group that did not receive ITM. In the postopoperative 48-hour follow-up, no VAS>4 value was observed in any one of the patients. Any intergroup difference was not detected as for length of hospital stay and complications associated with the method of analgesia used. DISCUSSION AND CONCLUSION: In conclusion, even though an adequate analgesia is ensured through ITM in thoracoscopic sympathectomy operations realized using clips method and a single port with the patient in the supine position,we think that admiinistration of morphine using IV PCA method may provide clinically acceptable analgesic efficacy, and a regional administration may not be required in patients who will be operated with this surgical technique.

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A practical guide for perioperative smoking cessation

et al. 2022

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Moderate-severe postoperative pain in patients undergoing video-assisted thoracoscopic surgery: A retrospective study

Cited by 60 publications

References 26 publications

<p>Characteristics of Postoperative Pain After VATS and Pain-Related Factors: The Experience in National Cancer Center of China</p>

<p>Characteristics of Postoperative Pain After VATS and Pain-Related Factors: The Experience in National Cancer Center of China</p>

Is Intravenous Morphine Alone Effective for Postoperative Analgesia in Bilateral, Single-port Video-Assisted Thoracoscopic Sympathectomy Performed in the Supine Position?

A practical guide for perioperative smoking cessation

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