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A Randomized Study Comparing the Incidence of Postoperative Pain After Phrenic Nerve Infiltration Vs Nonphrenic Nerve Infiltration During Thoracotomy

التفاصيل البيبلوغرافية
العنوان: A Randomized Study Comparing the Incidence of Postoperative Pain After Phrenic Nerve Infiltration Vs Nonphrenic Nerve Infiltration During Thoracotomy
المؤلفون: S.Y. Soon, Julie Morris, Z. Begum, Rajesh Shah, Nehru Devan, C. Fullwood, P. Krysiak, William R. Critchley, Ram Mohan, Bhuvaneswari Krishnamoorthy, Janesh Nair, Rashmi P. Birla, James E. Fildes, Ignacio Malagon
المصدر: Seminars in Thoracic and Cardiovascular Surgery, 31, 3, pp. 583-592
Seminars in Thoracic and Cardiovascular Surgery, 31, 583-592
سنة النشر: 2019
مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Spirometry, Male, Time Factors, medicine.medical_treatment, 030204 cardiovascular system & hematology, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, 0302 clinical medicine, Shoulder Pain, medicine, Humans, Thoracotomy, Anesthetics, Local, Pneumonectomy, Phrenic nerve, Aged, Pain Measurement, Bupivacaine, Aged, 80 and over, COPD, Pain, Postoperative, medicine.diagnostic_test, Patient-controlled analgesia, business.industry, Incidence, Nerve Block, General Medicine, Middle Aged, medicine.disease, Phrenic Nerve, Treatment Outcome, 030228 respiratory system, England, Back Pain, Anesthesia, Surgery, Female, Cardiology and Cardiovascular Medicine, business, Surgical incision, Infiltration (medical), medicine.drug
الوصف: Contains fulltext : 215252.pdf (Publisher’s version ) (Closed access) Thoracotomy is a common surgical procedure performed worldwide for lung disease. Despite major advances in analgesia, patients still experience severe shoulder, central back and surgical incision site pain in the postoperative period. This study aimed to assess whether intraoperative phrenic nerve infiltration reduces the incidence of postoperative pain and improves peak flow volume measurements during incentive spirometry. 90 patients undergoing open lobectomy were randomly assigned to have phrenic nerve infiltration (n=46) or not (n=44). The phrenic nerve infiltration group received 10 mL of 0.25% bupivacaine into the periphrenic fat pad. Preoperative assessments of spirometry and pain scores were recorded (at rest and with movement). Postoperative assessments included peak flow and pain measurements at intervals up to 72 hours. Less shoulder pain was experienced with phrenic nerve infiltration up to 6 hours postsurgery at rest (P = 0.005) and up to 12 hours with movement (P < 0.001). Reduced back pain was reported in the phrenic nerve infiltration group up to 6 hours after surgery both at rest (P = 0.001) and with movement (P = 0.00). Phrenic nerve infiltration reduced pain at the incision site for up to 3 hours both at rest (P < 0.001) and with movement (P = 0.001). Spirometry readings dropped in both groups with consistently lower readings at baseline and follow-up in the PNI group (P=0.007). Lower analgesic usage of patient controlled analgesia morphine (P < 0.0001), epipleural bupivacaine (P=0.001), and oramorph/zomorph (P=0.0002) were recorded. Our findings indicate that the use of phrenic nerve infiltration significantly reduced patient pain scores during the early postoperative period, particularly during movement. We believe that each technique has advantages and disadvantages; however, further studies with large sample size are warranted.
وصف الملف: application/pdf
تدمد: 1043-0679
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::054c401f84947b6f110e9e1263015c3b
https://hdl.handle.net/2066/215252
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....054c401f84947b6f110e9e1263015c3b
قاعدة البيانات: OpenAIRE
الوصف
تدمد:10430679