Analgesic efficacy of continuous erector spinae plane block vs. opioid‐based regimen for postoperative pain management following video‐assisted thoracoscopic lung resection: a prospective, randomised, open‐label, non‐inferiority trial
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Summary Introduction Video‐assisted thoracoscopic lung resection causes significant postoperative pain. We hypothesised that continuous erector spinae plane block would provide non‐inferior analgesia compared with a conventional opioid‐based regimen for this procedure. Methods Patients were allocated randomly to continuous erector spinae plane block (continuous infusion of 0.25% ropivacaine via perineural catheters (5 ml.h ‐1 ) combined with programmed intermittent bolus (10 ml every 6 h for the initial 24 h)) or conventional opioid‐based regimen (continuous infusion of opioid (2 μg.kg ‐1 sufentanil and 16 mg ondansetron diluted to 100 ml with 0.9% normal saline) at 2 ml.h ‐1 for 48 h). The primary outcome was overall analgesic efficacy with cough, quantified by the cumulative area under curve for the pain numeric rating scale scores, from post‐anaesthesia care unit discharge to 48 h postoperatively. Results The cumulative area under curve for the pain numeric rating scale score in patients allocated to the continuous erector spinae plane block group was non‐inferior to those allocated to the conventional group (mean difference − 0.99, 95%CI ‐11.97–9.98, p = 0.011). Patients allocated to the continuous erector spinae plane block group showed superior quality of recovery‐15 scores at 24 h (median difference 11, 95%CI 6–16, p < 0.001) and 48 h postoperatively (median difference 10, 95%CI 7–15, p < 0.001), alongside reduced postoperative pulmonary complications (relative risk 0.45, 95%CI 0.21–0.96, p = 0.031). Safety outcomes favoured continuous erector spinae plane block, with lower incidences of postoperative nausea (relative risk 0.17, 95%CI 0.04–0.73, p = 0.005); retching (relative risk 0.11, 95%CI 0.02–0.89, p = 0.023); and dizziness (relative risk 0.22, 95%CI 0.07–0.72, p = 0.005). Discussion Following video‐assisted thoracoscopic lung resection, continuous erector spinae plane block provides non‐inferior postoperative analgesia compared with conventional opioid‐based regimen whilst enhancing recovery quality significantly and reducing complications.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Analgesic efficacy of continuous erector spinae plane block vs. opioid‐based regimen for postoperative pain management following video‐assisted thoracoscopic lung resection: a prospective, randomised, open‐label, non‐inferiority trial
- Date Crossref
- 23/06/2025
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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First Affiliated Hospital of Guangzhou Medical University Department of Anaesthesiology pays non établi dans la noticeÉtablissement de santé
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First Affiliated Hospital of Guangzhou University of Chinese Medicine pays non établi dans la noticeÉtablissement de santé
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Guangzhou Medical University Cancer Hospital pays non établi dans la noticeÉtablissement de santé
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Guangzhou Medical University Department of Anaesthesiology pays non établi dans la noticeUniversité ou école supérieure
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Jiangmen Central Hospital pays non établi dans la noticeÉtablissement de santé
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Guangdong Clinical Research Academy of Chinese Medicine Guangzhou Guangdong China pays non établi dans la noticeÉtablissement de santé
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Department of Anaesthesiology Second People's Hospital of Jiangmen Jiangmen Guangdong China Department of Anaesthesiology pays non établi dans la noticeÉtablissement de santé
Department of Anaesthesiology — First Affiliated Hospital of Guangzhou Medical University, First Affiliated Hospital of Guangzhou University of Chinese Medicine et Guangzhou Medical University Cancer Hospital, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.