Patient-controlled intravenous analgesia with tramadol and lornoxicam after thoracotomy

Jin, Juying; Min, Su; Chen, Qibin; Zhang, Dong

doi:10.1097/md.0000000000014538

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…Some studies, particularly in thoracic surgery, have indicated that the traditional approach of PCIA is associated with inadequate pain relief and significant side-effects (eg, respiratory depression, nausea/vomiting, and pruritus), resulting in additional needs for analgesia and dissatisfaction. 2,3 However, the perioperative multimodal treatment (eg, regional anesthetic blockade and systemic administration of opioid analgesics and/or NSAIDs) is effective in management of acute postthoracotomy pain.…”

Section: Introductionmentioning

confidence: 99%

<p>Operation, Effectiveness, and Limitations of Continuous Serratus Anterior Plane Blocks for Thoracoscopic Surgery in Adults</p>

Yang

et al. 2020

JPR

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This randomized, double-blind study evaluated the effectiveness and limitations of continuous serratus anterior plane block (cSAPB) by comparing the effect of cSAPB to patient-controlled intravenous analgesia (PCIA) on postoperative acute pain after thoracoscopic surgery in adults. Patients and Methods: Sixty-six patients who underwent elective video-assisted thoracoscopic surgery (VATS) were randomly allocated to cSAPB or PCIA groups (n=33 per group) after surgery. For the cSAPB group, patients were treated by an initial does of 20 mL ropivacaine (0.375%), followed by continuous infusion at a rate of 5 mL/h of ropivacaine (0.2%) and a patient-controlled bolus of 5 mL ropivacaine (0.2%). PCIA started with an initial does of 0.03 µg/kg sufentanil, followed by a basal infusion of 0.03 µg/kg/h sufentanil and a patient-controlled bolus of 0.03 µg/kg sufentanil. Visual analog scale (VAS) and other items were examined postoperatively. The area under the curve of VAS-time (AUC VAS-time) at rest and on coughing in the first 24 hours postoperatively were primary outcomes. Results: At the first 24 hours postoperatively, patients in the cSAPB group exhibited a smaller AUC VAS-time at rest (44.0±17.1 vs 68.9±11.8 cm•h, P<0.001) and AUC VAS-time on coughing (67.1±8.8 vs 78.0±12.5 cm•h, P<0.001) compared with those in the PCIA group. The differences in means of VAS score at rest were more than 1.0 cm between the two groups, however, on coughing they were less than 1.0 cm at each observation point. Additionally, patients in the cSAPB group had a longer time to first patient-controlled bolus (15.8±7.6 vs 10.6±8.6 hours, P=0.011). Furthermore, a higher rank of satisfaction was recorded with patients in the cSAPB group. Conclusion: cSAPB using PCA devices might be superior to traditional intravenous continuous analgesia, particularly with an advantage of pain relief at rest following VATS operation. Meanwhile, cSAPB lacks a satisfactory analgesic effect on cough.

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Section: Introductionmentioning

confidence: 99%

<p>Operation, Effectiveness, and Limitations of Continuous Serratus Anterior Plane Blocks for Thoracoscopic Surgery in Adults</p>

Yang

et al. 2020

JPR

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“…PCIA is a common analgesic method after thoracoscopic surgery in clinics [27,28], and acupotomy is a traditional Chinese acupuncture treatment that focuses on the pain treatment of clinical diseases [29,30]. The combination of acupotomy and conventional PCIA can provide new insights into complicated postoperative pain management and functional rehabilitation of patients after thoracoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative acute pain is a common issue following thoracic surgery [1]. Although minimally invasive compared to the thoracotomy approach, postoperative pain arising from intercostal muscle, fascia, nerve, and visceral tissue injury after video-assisted thoracoscopic lung surgery must still be considered moderate to severe [2,3].…”

Section: Introductionmentioning

confidence: 99%

Postoperative analgesic effect of acupotomy combined with patient-controlled intravenous analgesia in patients undergoing video-assisted thoracoscopic surgery: A study protocol for a randomized controlled trial

Jiang

et al. 2020

Preprint

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Background: Postoperative acute pain is a common issue following thoracic surgery. Acupotomy is a common and safe intervention method for pain treatment in the clinic. In previous preliminary experiments, we found that acupotomy has a good clinical effect and safety in the treatment of pain after thoracoscopic surgery. However, due to a lack of rigorous design and adequate sample size, the efficacy still needs to be further confirmed. The purpose of this study will be to explore the efficacy and safety of acupotomy combined with patient-controlled intravenous analgesia (PCIA) for the treatment of pain after video-assisted thoracic surgery (VATS). Methods: The study will be a single-centre, parallel group, randomized controlled trial. Seventy patients with significant pain after thoracoscopic surgery with a visual analogue scale (VAS) score ≥7 will be included and randomly distributed into two groups: G1, the acupotomy combined with PCIA group; or G2, the conventional PCIA group. The primary outcome measure is pain scores at rest and coughing evaluated with the VAS by a blinded observer in the PACU and postoperatively at 1, 2, 4, 8, 12, 24, 48 and 72 h. The secondary outcome measures are postoperative requirements for rescue analgesia, the cumulative amount of self-administered analgesics, the level of sedation (LOS), Bruggemann comfort scale (BCS), and functional activity score (FAS) concerning adverse effects and patient satisfaction. Discussion: This trial has the potential to identify a novel strategy for postoperative pain management in VATS. Findings may advocate for the inclusion of the treatment of comorbid pain after thoracoscopy in current pain management practice guidelines.

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“…Jin et al reported similar pain control with TEA (ropivacaine and sufentanil combination) and IVA comprising tramadol and lornoxicam combination until the postoperative 4 th day. 23 Intravenous pethidine was also tested against intercostal blockade with bupivacaine and TEA with fentanyl.…”

Section: Discussionmentioning

confidence: 99%

Timelog-Based Approach to Early Post-Thoracotomy Pain in Lung Cancer Surgery

Omaygenç¹,

Çıtak²,

İşgörücü³

et al. 2019

Turkiye Klinikleri J Anest Reanim

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ostoperative pain is a determinant of quality of life and complication occurrence after thoracotomy. 1-3 Impaired chest wall integrity, rib fractures, intercostal neural damage and alteration of nociception are the main factors determining the intensity of pain. 1,2,4 Systemic analgesia and regional analgesia techniques can be utilized separately or as a combination treatment to provide adequate pain relief. Regional analgesia was frequently used at the last 20 years since its safety and efficacy was 39 Timelog-Based Approach to Early Post-Thoracotomy Pain in Lung Cancer Surgery A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Postoperative pain is a major concern about thoracotomy and acts a determinant of quality of life and complication occurrence. Here we sought to disctinctively assess the predictors of significant pain in the 1 st , 6 th , and 12 hours of elective lung cancer surgery. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Seventy American Society of Anesthesiologists (ASA) 1-3 patients who were performed posterolateral thoracotomy by the same surgical team were retrospectively recruited. Perception of pain was quantified by Visual Analogue Scale (VAS) and VAS scores of 1 st , 6 th and 12 th hours were recorded and a score of four or higher was identified as significant pain. Postoperative analgesia was provided either by thoracic epidural analgesia (TEA) with 0.1% bupivacaine or pethidine-based intravenous analgesia (IVA) in our sample population. R Re es su ul lt ts s: : Regarding demographic characteristics, there were almost no significant differences among groups with and without significant pain (Group Significant Pain, SP, and Group Tolerable Pain, TP; respectively) at the first 12 hours. Exceptions were the presence of higher rates of iatrogenic rib fracture (p=0.02) and operation related complications (p=0.046) in Group SP at 1 st and 6 th hours respectively. The frequency of patients treated with IVA was significantly higher in SP group at 1 st and 6 th hours but not at 12 th hour. C Co on nc cl lu us si io on n: : Type of analgesia was solely detected to be a persistent determinant of significant pain after lung cancer surgery. However, this was valid for only the first six hours.K Ke ey yw wo or rd ds s: : Analgesia, epidural; pain measurement; thoracotomy Ö ÖZ ZE ET T A Am ma aç ç: : Postoperatif ağrı torakotomiye ilişkin temel bir sorundur; ve sadece yaşam kalitesinde değil komplikasyon görülme sıklığında da belirleyici rol oynar. Bu çalışmada elektif akciğer kanser cerrahisi sonrası 1,6 ve 12. saatlerde kaydadeğer ağrıyı predikte eden etkenlerin birbirinden ayrı olarak tespit edilmesi hedeflenmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Aynı cerrahi ekip tarafından posterolateral torakotomi ile opere edilen 70 Amerikan Anesteziyoloji Derneği (ASA) 1-3 hastanın verileri retrospektif olarak incelendi. Vizüel Analog Skalası (VAS) ile sayısallaştırılan ağrı algısına dair skorların 1, 6 ve 12. saatlerdeki değerleri kaydedildi ve dört ve üzeri değerler ...

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Patient-controlled intravenous analgesia with tramadol and lornoxicam after thoracotomy

Cited by 9 publications

References 30 publications

<p>Operation, Effectiveness, and Limitations of Continuous Serratus Anterior Plane Blocks for Thoracoscopic Surgery in Adults</p>

<p>Operation, Effectiveness, and Limitations of Continuous Serratus Anterior Plane Blocks for Thoracoscopic Surgery in Adults</p>

Postoperative analgesic effect of acupotomy combined with patient-controlled intravenous analgesia in patients undergoing video-assisted thoracoscopic surgery: A study protocol for a randomized controlled trial

Timelog-Based Approach to Early Post-Thoracotomy Pain in Lung Cancer Surgery

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