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Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption

Background: Postoperative pain after video-assisted thoracoscopic surgery (VATS) affects patients’ recovery, postoperative complications, and length of stay (LOS). Despite its relevance, there are no guidelines on optimal perioperative pain management. This study aims to analyse the effects of an ad...

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Autores principales: Ponholzer, Florian, Ng, Caecilia, Maier, Herbert, Dejaco, Hannes, Schlager, Andreas, Lucciarini, Paolo, Öfner, Dietmar, Augustin, Florian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835787/
https://www.ncbi.nlm.nih.gov/pubmed/33478098
http://dx.doi.org/10.3390/jcm10020372
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author Ponholzer, Florian
Ng, Caecilia
Maier, Herbert
Dejaco, Hannes
Schlager, Andreas
Lucciarini, Paolo
Öfner, Dietmar
Augustin, Florian
author_facet Ponholzer, Florian
Ng, Caecilia
Maier, Herbert
Dejaco, Hannes
Schlager, Andreas
Lucciarini, Paolo
Öfner, Dietmar
Augustin, Florian
author_sort Ponholzer, Florian
collection PubMed
description Background: Postoperative pain after video-assisted thoracoscopic surgery (VATS) affects patients’ recovery, postoperative complications, and length of stay (LOS). Despite its relevance, there are no guidelines on optimal perioperative pain management. This study aims to analyse the effects of an additional intercostal catheter (ICC) in comparison to a single shot intraoperative intercostal nerve block (SSINB). Methods: All patients receiving an anatomic VATS resection between June 2019 and May 2020 were analysed retrospectively. The ICC cohort included 51 patients, the SSINB cohort included 44 patients. Results: There was no difference in age, gender, comorbidities, or duration of surgery between cohorts. Pain scores on the first postoperative day, after chest drain removal, and highest pain score measured did not differ between groups. The overall amount of opioids (morphine equivalent: 3.034 mg vs. 7.727 mg; p = 0.002) as well as the duration of opioid usage (0.59 days vs. 1.25 days; p = 0.005) was significantly less in the ICC cohort. There was no difference in chest drain duration, postoperative complications, and postoperative LOS. Conclusions: Pain management with ICC reduces the amount of opioids and number of days with opioids patients require to achieve sufficient analgesia. In conclusion, ICC is an effective regional anaesthesia tool in postoperative pain management in minimally invasive thoracic surgery.
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spelling pubmed-78357872021-01-27 Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption Ponholzer, Florian Ng, Caecilia Maier, Herbert Dejaco, Hannes Schlager, Andreas Lucciarini, Paolo Öfner, Dietmar Augustin, Florian J Clin Med Article Background: Postoperative pain after video-assisted thoracoscopic surgery (VATS) affects patients’ recovery, postoperative complications, and length of stay (LOS). Despite its relevance, there are no guidelines on optimal perioperative pain management. This study aims to analyse the effects of an additional intercostal catheter (ICC) in comparison to a single shot intraoperative intercostal nerve block (SSINB). Methods: All patients receiving an anatomic VATS resection between June 2019 and May 2020 were analysed retrospectively. The ICC cohort included 51 patients, the SSINB cohort included 44 patients. Results: There was no difference in age, gender, comorbidities, or duration of surgery between cohorts. Pain scores on the first postoperative day, after chest drain removal, and highest pain score measured did not differ between groups. The overall amount of opioids (morphine equivalent: 3.034 mg vs. 7.727 mg; p = 0.002) as well as the duration of opioid usage (0.59 days vs. 1.25 days; p = 0.005) was significantly less in the ICC cohort. There was no difference in chest drain duration, postoperative complications, and postoperative LOS. Conclusions: Pain management with ICC reduces the amount of opioids and number of days with opioids patients require to achieve sufficient analgesia. In conclusion, ICC is an effective regional anaesthesia tool in postoperative pain management in minimally invasive thoracic surgery. MDPI 2021-01-19 /pmc/articles/PMC7835787/ /pubmed/33478098 http://dx.doi.org/10.3390/jcm10020372 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ponholzer, Florian
Ng, Caecilia
Maier, Herbert
Dejaco, Hannes
Schlager, Andreas
Lucciarini, Paolo
Öfner, Dietmar
Augustin, Florian
Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption
title Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption
title_full Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption
title_fullStr Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption
title_full_unstemmed Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption
title_short Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption
title_sort intercostal catheters for postoperative pain management in vats reduce opioid consumption
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835787/
https://www.ncbi.nlm.nih.gov/pubmed/33478098
http://dx.doi.org/10.3390/jcm10020372
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