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  • Title: [Postoperative Analgesia for Video-assisted Thoracoscopic Surgery--Continuous Intravenous Infusion of Fentanyl Combined with Intercostal Nerve Block v.s. Continuous Epidural Analgesia].
    Author: Hiro K, Sugiyama T, Kurata M, Oi Y, Okuda M.
    Journal: Masui; 2016 Feb; 65(2):114-8. PubMed ID: 27017761.
    Abstract:
    BACKGROUND: Epidural analgesia or paravertebral block is widely used in postoperative analgesia for video-assisted thoracic surgery (VATS). We investigated the efficacy of the continuous intravenous infuion of fentanyl combined with intercostal nerve block, in comparison with the continuous epidural analgesia. METHODS: Forty-one patients received a bolus of 0.375% ropivacaine 6-10 ml through the epidural catheter placed at the T5-9 at the end of surgery. Then, continuous epidural infusion of 0.2% ropivacaine at a rate of 4 or 6 ml x hr(-1) was started (Group E). 44 patients received intercostal nerve block at three insertion points of thoracoscopy (using 0.75% ropivacaine 3-4 ml, respectively) at the end of surgery. Then, continuous intravenous infusion of fentanyl at a rate of 0.5 μg x kg(-1) x hr(-1) was started (Group F). The efficacy of post-operative analgesia was evaluated by additional analgesic requirements. RESULTS : There was no significant difference in the additional analgesic requirements between the two groups. However, the additional analgesics were required significantly earlier in Group E than Group F (P < 0.05). CONCLUSIONS: Continuous intravenous infusion of fentanyl combined with intercostal nerve block is effective in the postoperative analgesia for VATS, as well as continuous epidural analgesia.
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