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Abstract
Background and Aims The purpose of this study was to evaluate whether using a cocktail of intercostal nerve blocks during thoracoscopic surgery results in better clinical outcomes than using patient-controlled analgesia.
Methods Patients who underwent video-assisted thoracoscopic surgery (VATS) from the same medical group in West China Hospital of Sichuan University during 2021, June to 2022, June were enrolled. The groups were divided into two subgroups based on their analgesic program, which were thoracoscopic intercostal nerve block group (TINB group) and patient-controlled intravenous analgesia group (PCIA group). After propensity score matching (PSM), We assessed the patients‘ pain at different time points after surgery using the visual analogue scale (VAS) and recorded any analgesic related adverse events (ARAEs).
Results The difference of resting VAS (RVAS) and active VAS (AVAS) at different stage during hospitalization was only related to the change of period, and the two groups showed no significant differences in RVAS or AVAS during hospitalization. However, the rates of dizziness (4.92% vs 26.23%, p < 0.05), nausea and vomiting (0 vs 22.95%, p < 0.05), fatigue (4.75% vs 34.43%, p < 0.05), and insomnia (0 vs 59.02%, p < 0.05) in TINB group were significantly lower than that in PICA group. Besides, AVAS and RVAS at 7, 14, and 30 days after discharge in TINB group were both significantly lower than that in PICA group (p < 0.05, p < 0.05).
central picture of TINBs
Conclusions Based on this single-center analysis, cocktail analgesia TINB provided better analgesia after discharge and reduced the incidence of ARAEs in patients undergoing VATS.