Intercostal Catheters Reduce Long-Term Pain and Postoperative Opioid Consumption after VATS
: Pain after video-assisted thoracoscopic surgery (VATS) leads to impaired postoperative recovery, possible side effects of opioid usage, and higher rates of chronic post-surgery pain (CPSP). Nevertheless, guidelines on perioperative pain management for VATS patients are lacking. The aim of this stu...
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| Veröffentlicht in: | Journal of clinical medicine 2024-05, Vol.13 (10), p.2842 |
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| creator | Neuschmid, Marie-Christin Ponholzer, Florian Ng, Caecilia Maier, Herbert Dejaco, Hannes Lucciarini, Paolo Schneeberger, Stefan Augustin, Florian |
| description | : Pain after video-assisted thoracoscopic surgery (VATS) leads to impaired postoperative recovery, possible side effects of opioid usage, and higher rates of chronic post-surgery pain (CPSP). Nevertheless, guidelines on perioperative pain management for VATS patients are lacking. The aim of this study was to analyze the effectiveness of intercostal catheters in combination with a single shot intraoperative intercostal nerve block (SSINB) in comparison to SSINB alone with respect to opioid consumption and CPSP.
: Patients receiving an anatomic VATS resection between 2019 and 2022 for primary lung cancer were retrospectively analyzed. A total of 75 consecutive patients receiving an ICC and SSINB and 75 consecutive patients receiving only SSINB were included in our database. After enforcing the exclusion criteria (insufficient documentation, external follow-ups, or patients receiving opioids on a fixed schedule;
= 9) 141 patients remained for further analysis.
: The ICC and No ICC cohort were comparable in age, gender distribution, tumor location and hospital stay. Patients in the ICC cohort showed significantly less opioid usage regarding the extent (4.48 ± 6.69 SD vs. 7.23 ± 7.55 SD mg,
= 0.023), duration (0.76 ± 0.97 SD vs. 1.26 ± 1.33 SD days,
= 0.012) and frequency (0.90 ± 1.34 SD vs. 1.45 ± 1.51 SD times,
= 0.023) in comparison to the No ICC group. During the first nine months of oncological follow-up assessments, no statistical difference was found in the rate of patients experiencing postoperative pain, although a trend towards less pain in the ICC cohort was found. One year after surgery, the ICC cohort expressed significantly less often pain (1.5 vs. 10.8%,
= 0.035).
: Placement of an ICC provides VATS patients with improved postoperative pain relief resulting in a reduced frequency of required opioid administration, less days with opioids, and a reduced total amount of opioids consumed. Furthermore, ICC patients have significantly lower rates of CPSP one year after surgery. |
| doi_str_mv | 10.3390/jcm13102842 |
| format | Article |
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: Patients receiving an anatomic VATS resection between 2019 and 2022 for primary lung cancer were retrospectively analyzed. A total of 75 consecutive patients receiving an ICC and SSINB and 75 consecutive patients receiving only SSINB were included in our database. After enforcing the exclusion criteria (insufficient documentation, external follow-ups, or patients receiving opioids on a fixed schedule;
= 9) 141 patients remained for further analysis.
: The ICC and No ICC cohort were comparable in age, gender distribution, tumor location and hospital stay. Patients in the ICC cohort showed significantly less opioid usage regarding the extent (4.48 ± 6.69 SD vs. 7.23 ± 7.55 SD mg,
= 0.023), duration (0.76 ± 0.97 SD vs. 1.26 ± 1.33 SD days,
= 0.012) and frequency (0.90 ± 1.34 SD vs. 1.45 ± 1.51 SD times,
= 0.023) in comparison to the No ICC group. During the first nine months of oncological follow-up assessments, no statistical difference was found in the rate of patients experiencing postoperative pain, although a trend towards less pain in the ICC cohort was found. One year after surgery, the ICC cohort expressed significantly less often pain (1.5 vs. 10.8%,
= 0.035).
: Placement of an ICC provides VATS patients with improved postoperative pain relief resulting in a reduced frequency of required opioid administration, less days with opioids, and a reduced total amount of opioids consumed. Furthermore, ICC patients have significantly lower rates of CPSP one year after surgery.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm13102842</identifier><identifier>PMID: 38792384</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Analgesics ; Catheters ; Chronic pain ; Complications and side effects ; Dosage and administration ; Drug therapy ; Epidural ; Lung cancer ; Methods ; Morphine ; Narcotics ; Opioids ; Ostomy ; Pain management ; Pain, Postoperative ; Patient outcomes ; Patients ; Prevention ; Risk factors ; Statistical analysis ; Thoracic surgery ; Thoracoscopy</subject><ispartof>Journal of clinical medicine, 2024-05, Vol.13 (10), p.2842</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 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 (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c379t-d7be1e1907426f314bacf0fcb520ea13ce876b85cf35af4b70a7ae306df259353</cites><orcidid>0000-0002-2619-8639 ; 0000-0002-6785-4241 ; 0000-0003-3486-7166</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38792384$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neuschmid, Marie-Christin</creatorcontrib><creatorcontrib>Ponholzer, Florian</creatorcontrib><creatorcontrib>Ng, Caecilia</creatorcontrib><creatorcontrib>Maier, Herbert</creatorcontrib><creatorcontrib>Dejaco, Hannes</creatorcontrib><creatorcontrib>Lucciarini, Paolo</creatorcontrib><creatorcontrib>Schneeberger, Stefan</creatorcontrib><creatorcontrib>Augustin, Florian</creatorcontrib><title>Intercostal Catheters Reduce Long-Term Pain and Postoperative Opioid Consumption after VATS</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>: Pain after video-assisted thoracoscopic surgery (VATS) leads to impaired postoperative recovery, possible side effects of opioid usage, and higher rates of chronic post-surgery pain (CPSP). Nevertheless, guidelines on perioperative pain management for VATS patients are lacking. The aim of this study was to analyze the effectiveness of intercostal catheters in combination with a single shot intraoperative intercostal nerve block (SSINB) in comparison to SSINB alone with respect to opioid consumption and CPSP.
: Patients receiving an anatomic VATS resection between 2019 and 2022 for primary lung cancer were retrospectively analyzed. A total of 75 consecutive patients receiving an ICC and SSINB and 75 consecutive patients receiving only SSINB were included in our database. After enforcing the exclusion criteria (insufficient documentation, external follow-ups, or patients receiving opioids on a fixed schedule;
= 9) 141 patients remained for further analysis.
: The ICC and No ICC cohort were comparable in age, gender distribution, tumor location and hospital stay. Patients in the ICC cohort showed significantly less opioid usage regarding the extent (4.48 ± 6.69 SD vs. 7.23 ± 7.55 SD mg,
= 0.023), duration (0.76 ± 0.97 SD vs. 1.26 ± 1.33 SD days,
= 0.012) and frequency (0.90 ± 1.34 SD vs. 1.45 ± 1.51 SD times,
= 0.023) in comparison to the No ICC group. During the first nine months of oncological follow-up assessments, no statistical difference was found in the rate of patients experiencing postoperative pain, although a trend towards less pain in the ICC cohort was found. One year after surgery, the ICC cohort expressed significantly less often pain (1.5 vs. 10.8%,
= 0.035).
: Placement of an ICC provides VATS patients with improved postoperative pain relief resulting in a reduced frequency of required opioid administration, less days with opioids, and a reduced total amount of opioids consumed. Furthermore, ICC patients have significantly lower rates of CPSP one year after surgery.</description><subject>Analgesics</subject><subject>Catheters</subject><subject>Chronic pain</subject><subject>Complications and side effects</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Epidural</subject><subject>Lung cancer</subject><subject>Methods</subject><subject>Morphine</subject><subject>Narcotics</subject><subject>Opioids</subject><subject>Ostomy</subject><subject>Pain management</subject><subject>Pain, Postoperative</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prevention</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Thoracic surgery</subject><subject>Thoracoscopy</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpt0c9LHDEUB_BQlCrrnnovAS9CGZvMm9lMjstiVVhQdNtLD0Mm82KzzCRjMlPof2-W1VaLySE_-LwvDx4hnzg7B5Ds61b3HDjLqyL_QI5zJkTGoIKDV_cjMo9xy9KqkuLiIzmCSsgcquKY_Lx2Iwbt46g6ulLjL0zPSO-wnTTStXcP2QZDT2-VdVS5lt4m6gcMarS_kd4M1tuWrryLUz-M1idkUgL9sdzcn5BDo7qI8-dzRr5_u9isrrL1zeX1arnONAg5Zq1okCOXTBT5wgAvGqUNM7opc4aKg8ZKLJqq1AZKZYpGMCUUAlu0Ji8llDAjZ_vcIfjHCeNY9zZq7Drl0E-xTpSB4EyyRE__o1s_BZe6S6qURckWRfFPPagOa-uMH4PSu9B6KWQJklf5Tp2_o9JusbfaOzQ2_b8p-LIv0MHHGNDUQ7C9Cn9qzurdNOtX00z683OrU9Nj-9e-zA6eAAcMl-A</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Neuschmid, Marie-Christin</creator><creator>Ponholzer, Florian</creator><creator>Ng, Caecilia</creator><creator>Maier, Herbert</creator><creator>Dejaco, Hannes</creator><creator>Lucciarini, Paolo</creator><creator>Schneeberger, Stefan</creator><creator>Augustin, Florian</creator><general>MDPI AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2619-8639</orcidid><orcidid>https://orcid.org/0000-0002-6785-4241</orcidid><orcidid>https://orcid.org/0000-0003-3486-7166</orcidid></search><sort><creationdate>20240501</creationdate><title>Intercostal Catheters Reduce Long-Term Pain and Postoperative Opioid Consumption after VATS</title><author>Neuschmid, Marie-Christin ; 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Nevertheless, guidelines on perioperative pain management for VATS patients are lacking. The aim of this study was to analyze the effectiveness of intercostal catheters in combination with a single shot intraoperative intercostal nerve block (SSINB) in comparison to SSINB alone with respect to opioid consumption and CPSP.
: Patients receiving an anatomic VATS resection between 2019 and 2022 for primary lung cancer were retrospectively analyzed. A total of 75 consecutive patients receiving an ICC and SSINB and 75 consecutive patients receiving only SSINB were included in our database. After enforcing the exclusion criteria (insufficient documentation, external follow-ups, or patients receiving opioids on a fixed schedule;
= 9) 141 patients remained for further analysis.
: The ICC and No ICC cohort were comparable in age, gender distribution, tumor location and hospital stay. Patients in the ICC cohort showed significantly less opioid usage regarding the extent (4.48 ± 6.69 SD vs. 7.23 ± 7.55 SD mg,
= 0.023), duration (0.76 ± 0.97 SD vs. 1.26 ± 1.33 SD days,
= 0.012) and frequency (0.90 ± 1.34 SD vs. 1.45 ± 1.51 SD times,
= 0.023) in comparison to the No ICC group. During the first nine months of oncological follow-up assessments, no statistical difference was found in the rate of patients experiencing postoperative pain, although a trend towards less pain in the ICC cohort was found. One year after surgery, the ICC cohort expressed significantly less often pain (1.5 vs. 10.8%,
= 0.035).
: Placement of an ICC provides VATS patients with improved postoperative pain relief resulting in a reduced frequency of required opioid administration, less days with opioids, and a reduced total amount of opioids consumed. Furthermore, ICC patients have significantly lower rates of CPSP one year after surgery.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>38792384</pmid><doi>10.3390/jcm13102842</doi><orcidid>https://orcid.org/0000-0002-2619-8639</orcidid><orcidid>https://orcid.org/0000-0002-6785-4241</orcidid><orcidid>https://orcid.org/0000-0003-3486-7166</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analgesics Catheters Chronic pain Complications and side effects Dosage and administration Drug therapy Epidural Lung cancer Methods Morphine Narcotics Opioids Ostomy Pain management Pain, Postoperative Patient outcomes Patients Prevention Risk factors Statistical analysis Thoracic surgery Thoracoscopy |
| title | Intercostal Catheters Reduce Long-Term Pain and Postoperative Opioid Consumption after VATS |
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