Regional analgesia for video-assisted thoracic surgery – a systematic review
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Regional analgesia for video-assisted thoracic surgery – a systematic review. / Julia Steinthorsdottir, Kristin; Wildgaard, Lorna ; Jessen Hansen, Henrik; Petersen, René Horsleben; Wildgaard, Kim.
I: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 11.2013.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Regional analgesia for video-assisted thoracic surgery – a systematic review
AU - Julia Steinthorsdottir, Kristin
AU - Wildgaard, Lorna
AU - Jessen Hansen, Henrik
AU - Petersen, René Horsleben
AU - Wildgaard, Kim
PY - 2013/11
Y1 - 2013/11
N2 - Video-assisted thoracic surgery (VATS) is emerging as the standard surgical procedure for both minor and major oncologic lung surgery. Thoracic epidural analgesia (TEA) and paravertebral block (PVB) are established analgesic golden standards for open surgery such as thoracotomy; however there is no gold standard for regional analgesia for VATS. This systematic review aimed to assess different regional techniques in regards to effect on acute post-operative pain following VATS, with emphasis on VATS lobectomy. The systematic review of the PubMed, Cochrane Library and Embase databases yielded unique 1542 abstracts, 17 articles were included for qualitative assessment, of which 3 were studies on VATS lobectomy. The analgesic techniques included TEA, multilevel- and single PVB, paravertebral catheter, intercostal catheter, interpleural infusion and long thoracic nerve block. Overall the studies were heterogeneous with small numbers of participants. In comparative studies TEA and especially PVB showed some effect on pain scores, but were often compared to inferior analgesic treatment. Other techniques showed no unequivocal results. No clear gold standard for regional analgesia for VATS could be demonstrated, but a guide of factors to include in future studies on regional analgesia for VATS is presented.
AB - Video-assisted thoracic surgery (VATS) is emerging as the standard surgical procedure for both minor and major oncologic lung surgery. Thoracic epidural analgesia (TEA) and paravertebral block (PVB) are established analgesic golden standards for open surgery such as thoracotomy; however there is no gold standard for regional analgesia for VATS. This systematic review aimed to assess different regional techniques in regards to effect on acute post-operative pain following VATS, with emphasis on VATS lobectomy. The systematic review of the PubMed, Cochrane Library and Embase databases yielded unique 1542 abstracts, 17 articles were included for qualitative assessment, of which 3 were studies on VATS lobectomy. The analgesic techniques included TEA, multilevel- and single PVB, paravertebral catheter, intercostal catheter, interpleural infusion and long thoracic nerve block. Overall the studies were heterogeneous with small numbers of participants. In comparative studies TEA and especially PVB showed some effect on pain scores, but were often compared to inferior analgesic treatment. Other techniques showed no unequivocal results. No clear gold standard for regional analgesia for VATS could be demonstrated, but a guide of factors to include in future studies on regional analgesia for VATS is presented.
KW - Faculty of Health and Medical Sciences
KW - Pain
KW - post-operative
KW - regional analgesia
KW - thoracoscopic, VATS, Video-assisted thoracic surgery
U2 - 10.1093/ejcts/ezt525
DO - 10.1093/ejcts/ezt525
M3 - Journal article
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
ER -
ID: 49732955