Abstract：
BACKGROUND: Intercostal nerve block (ICNB) is a very effective analgesic method. We aimed to explore the effect of preemptive analgesia with ultrasound-guided intercostal nerve block on postoperative analgesia in thoracoscopic surgery.
METHODS: 126 patients, aged 18-70 years, with American Society of Anesthesiologists (ASA) physical status I-II and scheduled for thoracoscopic pulmonary resection were enrolled in this study. 119 patients were left for final analysis. Patients were randomly allocated to group ICNB and group CONTROL. Patients in CONTROL group were administered sufentanil with patient-controlled analgesia device after operation In group ICNB, patients received ropivacaine ICNB prior to surgery and patient-controlled analgesia device after operation. The primary outcome is visual analog scale pain score (VAS) at rest at 0,4, 8,16,24,48,72 and 168 h postoperatively and they were compared. Surgical outcomes and rescue analgesia requirement were also recorded.
RESULTS: VAS scores were statistically significantly lower for ICNB group compared to control group at 0, 4, 8, 16, 24 and 48 h postoperatively. The duration of insertion of chest tube in ICBN group was shorter than that in control group, and the difference was statistically significant (4.69 ± 2.14 vs. 5.67 ± 2.86, P = 0.036). The postoperative hospital stay, incidence of nausea and vomiting and postoperative pulmonary infection rate in ICBN group were all lower than those in the control group, but there were no statistical differences. The frequency of rescue analgesia during 48 postoperative hours was different between the two groups (ICNB vs. Control; 9.83% vs. 31.03%, P = 0.004).
CONCLUSIONS: For patients undergoing thoracoscopic surgery, ultrasound-guided ICNB is simple, safe, and effective for providing acute postoperative pain management during the early postoperative stage.
BACKGROUND: Chinese clinical trials: chictr.org.cn, ChiCTR1900021017. Registred on 25/01/2019.
METHODS: 126 patients, aged 18-70 years, with American Society of Anesthesiologists (ASA) physical status I-II and scheduled for thoracoscopic pulmonary resection were enrolled in this study. 119 patients were left for final analysis. Patients were randomly allocated to group ICNB and group CONTROL. Patients in CONTROL group were administered sufentanil with patient-controlled analgesia device after operation In group ICNB, patients received ropivacaine ICNB prior to surgery and patient-controlled analgesia device after operation. The primary outcome is visual analog scale pain score (VAS) at rest at 0,4, 8,16,24,48,72 and 168 h postoperatively and they were compared. Surgical outcomes and rescue analgesia requirement were also recorded.
RESULTS: VAS scores were statistically significantly lower for ICNB group compared to control group at 0, 4, 8, 16, 24 and 48 h postoperatively. The duration of insertion of chest tube in ICBN group was shorter than that in control group, and the difference was statistically significant (4.69 ± 2.14 vs. 5.67 ± 2.86, P = 0.036). The postoperative hospital stay, incidence of nausea and vomiting and postoperative pulmonary infection rate in ICBN group were all lower than those in the control group, but there were no statistical differences. The frequency of rescue analgesia during 48 postoperative hours was different between the two groups (ICNB vs. Control; 9.83% vs. 31.03%, P = 0.004).
CONCLUSIONS: For patients undergoing thoracoscopic surgery, ultrasound-guided ICNB is simple, safe, and effective for providing acute postoperative pain management during the early postoperative stage.
BACKGROUND: Chinese clinical trials: chictr.org.cn, ChiCTR1900021017. Registred on 25/01/2019.
摘要：
背景：肋间神经阻滞（ICNB）是一种非常有效的镇痛方法。目的探讨超声引导下肋间神经阻滞超前镇痛对胸腔镜手术术后镇痛的影响。
方法：126例患者，18-70岁,这项研究纳入了美国麻醉医师协会（ASA）的身体状态I-II，并计划进行胸腔镜肺切除术。119例患者留待最终分析。患者随机分为ICNB组和对照组。对照组患者术后给予舒芬太尼患者自控镇痛装置。患者在手术前接受罗哌卡因ICNB,术后接受患者自控镇痛装置.主要结果是术后0、4、8、16、24、48、72和168h休息时的视觉模拟疼痛评分（VAS），并进行比较。还记录了手术结果和抢救镇痛需求。
结果：术后0、4、8、16、24和48h，ICNB组的VAS评分明显低于对照组。ICBN组胸管置入时间短于对照组,差异有统计学意义(4.69±2.14vs.5.67±2.86,P=0.036)。术后住院时间,ICBN组恶心呕吐发生率及术后肺部感染率均低于对照组,但没有统计学差异。两组术后48小时内抢救镇痛的频率不同(ICNBvs.对照；9.83%与31.03%,P=0.004)。
结论：对于接受胸腔镜手术的患者，超声引导ICNB是简单的，安全,并有效地在术后早期提供急性术后疼痛管理。
背景：中国临床试验：chictr.org.cn,ChiCTR1900021017。于2019年1月25日注册。
方法：126例患者，18-70岁,这项研究纳入了美国麻醉医师协会（ASA）的身体状态I-II，并计划进行胸腔镜肺切除术。119例患者留待最终分析。患者随机分为ICNB组和对照组。对照组患者术后给予舒芬太尼患者自控镇痛装置。患者在手术前接受罗哌卡因ICNB,术后接受患者自控镇痛装置.主要结果是术后0、4、8、16、24、48、72和168h休息时的视觉模拟疼痛评分（VAS），并进行比较。还记录了手术结果和抢救镇痛需求。
结果：术后0、4、8、16、24和48h，ICNB组的VAS评分明显低于对照组。ICBN组胸管置入时间短于对照组,差异有统计学意义(4.69±2.14vs.5.67±2.86,P=0.036)。术后住院时间,ICBN组恶心呕吐发生率及术后肺部感染率均低于对照组,但没有统计学差异。两组术后48小时内抢救镇痛的频率不同(ICNBvs.对照；9.83%与31.03%,P=0.004)。
结论：对于接受胸腔镜手术的患者，超声引导ICNB是简单的，安全,并有效地在术后早期提供急性术后疼痛管理。
背景：中国临床试验：chictr.org.cn,ChiCTR1900021017。于2019年1月25日注册。
