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Retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study

BACKGROUND: The role of thoracic epidural analgesia (TEA) for postoperative analgesia after video-assisted thoracic surgery (VATS) is still controversial. Some studies have reported the efficacy of ultrasound-guided retrolaminar block (RLB) for the postoperative management of pain after chest wall s...

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Autores principales: Nobukuni, Keiko, Hatta, Mariko, Nakagaki, Toshiaki, Yoshino, Jun, Obuchi, Toshiro, Fujimura, Naoyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182553/
https://www.ncbi.nlm.nih.gov/pubmed/34164168
http://dx.doi.org/10.21037/jtd-21-238
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author Nobukuni, Keiko
Hatta, Mariko
Nakagaki, Toshiaki
Yoshino, Jun
Obuchi, Toshiro
Fujimura, Naoyuki
author_facet Nobukuni, Keiko
Hatta, Mariko
Nakagaki, Toshiaki
Yoshino, Jun
Obuchi, Toshiro
Fujimura, Naoyuki
author_sort Nobukuni, Keiko
collection PubMed
description BACKGROUND: The role of thoracic epidural analgesia (TEA) for postoperative analgesia after video-assisted thoracic surgery (VATS) is still controversial. Some studies have reported the efficacy of ultrasound-guided retrolaminar block (RLB) for the postoperative management of pain after chest wall surgery. The purpose of this study was to compare the postoperative analgesic efficacy and adverse effects of ultrasound-guided RLB with those of TEA in patients undergoing minor VATS procedures. METHODS: A total of 192 relevant records of patients were enrolled in this study. We reviewed electronic medical records of patients undergoing minor VATS procedures under general anesthesia. The primary outcome was the median differences in the numerical rating scale (NRS) scores during rest between the groups at the morning of postoperative day 1 (POD 1m). A propensity-matched analysis incorporating preoperative variables was used to compare the efficacy of postoperative analgesia in two groups. RESULTS: Overall, 94 patients were identified for analysis. Propensity score matching resulted in 47 patients in each group. There were no significant differences in the NRS scores between the two groups. The median differences in NRS scores during rest between the two groups at POD 1m were under 1, which indicates non-inferiority of RLB. There were no significant differences in the incidence of adverse effects and rescue dose of analgesic consumption between the two groups. CONCLUSIONS: The analgesic effects of continuous ultrasound-guided RLB were non inferior to those of TEA for minor VATS procedures.
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spelling pubmed-81825532021-06-22 Retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study Nobukuni, Keiko Hatta, Mariko Nakagaki, Toshiaki Yoshino, Jun Obuchi, Toshiro Fujimura, Naoyuki J Thorac Dis Original Article BACKGROUND: The role of thoracic epidural analgesia (TEA) for postoperative analgesia after video-assisted thoracic surgery (VATS) is still controversial. Some studies have reported the efficacy of ultrasound-guided retrolaminar block (RLB) for the postoperative management of pain after chest wall surgery. The purpose of this study was to compare the postoperative analgesic efficacy and adverse effects of ultrasound-guided RLB with those of TEA in patients undergoing minor VATS procedures. METHODS: A total of 192 relevant records of patients were enrolled in this study. We reviewed electronic medical records of patients undergoing minor VATS procedures under general anesthesia. The primary outcome was the median differences in the numerical rating scale (NRS) scores during rest between the groups at the morning of postoperative day 1 (POD 1m). A propensity-matched analysis incorporating preoperative variables was used to compare the efficacy of postoperative analgesia in two groups. RESULTS: Overall, 94 patients were identified for analysis. Propensity score matching resulted in 47 patients in each group. There were no significant differences in the NRS scores between the two groups. The median differences in NRS scores during rest between the two groups at POD 1m were under 1, which indicates non-inferiority of RLB. There were no significant differences in the incidence of adverse effects and rescue dose of analgesic consumption between the two groups. CONCLUSIONS: The analgesic effects of continuous ultrasound-guided RLB were non inferior to those of TEA for minor VATS procedures. AME Publishing Company 2021-05 /pmc/articles/PMC8182553/ /pubmed/34164168 http://dx.doi.org/10.21037/jtd-21-238 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Nobukuni, Keiko
Hatta, Mariko
Nakagaki, Toshiaki
Yoshino, Jun
Obuchi, Toshiro
Fujimura, Naoyuki
Retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study
title Retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study
title_full Retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study
title_fullStr Retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study
title_full_unstemmed Retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study
title_short Retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study
title_sort retrolaminar versus epidural block for postoperative analgesia after minor video-assisted thoracic surgery: a retrospective, matched, non-inferiority study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182553/
https://www.ncbi.nlm.nih.gov/pubmed/34164168
http://dx.doi.org/10.21037/jtd-21-238
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