Abstract
Objective
The aim of this randomized controlled trial is to evaluate U/S guided serratus anterior plane catheter block (SAPB) versus patient‐controlled analgesia (PCA) on the emergence of post‐thoracotomy pain syndrome (PTPS) after thoracotomies for thoracic tumors.
Methods
This trial included 89 patients with chest malignancies, scheduled for thoracotomy were randomly allocated into two groups: Group A "PCA–group N=44" receiving patient‐controlled analgesia and group B "SAPB group N=45" where analgesia was provided by serratus anterior plane catheter block. The primary outcome measure was the assessment for the possible emergence of PTPS at 12 weeks. The secondary outcome measures were pain relief measured by visual analog scale (VAS) score, Quality of life was assessed by Flanagan Quality of Life Scale (QOLS) and Activity level was assessed by Barthel Activity of daily living (ADL) score.
Results
At week 8, PTPS incidence was significantly (P=0.037) higher in the PCA group (45%) than in the SAPB group (24%) with a relative risk of 1.38 and 95 % CI (1.01 to 1.9) while the incidence of PTPS at week 12 was significantly (P= 0.035) higher in the PCA group (43%) than in the SAPB group (22%) with a relative risk of 2.38 and 95 % CI (1.23 to 4.57). The need for pain therapy in PTPS patients was significantly lower in the SAPB group (17.7%) than PCA group (38.6%) (P= 0.028) at week 12. Pain intensity: VAS‐R and VAS‐D (pain scores at rest and with activity, respectively) were comparable (P > 0.05) between both groups at 6, 12, 18 and 24 hours, however VAS was significantly higher in the PCA group at week 8 (P = 0.046) and week 12 (P = 0.032) . Both groups were comparable regarding ADL and QOL scores (P > 0.05).
Conclusion
SAPB is assumed to be a good alternative for post‐thoracotomy analgesia following thoracotomies. The current work hypothesized that SAPB for a week postoperatively, may reduce the emergence of PTPS and may reduce the demand for pain therapy in those patients.
This article is protected by copyright. All rights reserved.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/30AFLgg
via IFTTT
No comments:
Post a Comment