PDF(Pubmed)
Abstract：
Although video-assisted thoracoscopic surgery (VATS) has advantages of reduced injury and faster healing, patients still endure moderate and severe postoperative pain. Paracetamol and mannitol injection, the first acetaminophen injection in China, has the advantages of convenient administration, rapid onset of action, and no first-pass effect. This aim of this study was to investigate the efficacy of postoperative analgesia with paracetamol and mannitol injection, combined with thoracic paravertebral nerve block (TPVB) in post VATS pain.
This study was a single-center, prospective, randomized, double-blind controlled clinical trial. Patients scheduled for VATS were randomly divided into three groups, general anesthesia group (Group C), TPVB group (Group T) and TPVB + paracetamol and mannitol injection group (Group TP). In this study, the primary outcome was determined as visual analog scale (VAS) scores at rest and coughing, the secondary observation outcomes were the first time to use analgesic pump, the total consumption of oxycodone in the analgesic pump, number of effective and total analgesic pump compressions at first 48 h postoperatively, the perioperative consumption of sufentanil, time to extubation, hospital length of stay, urine volume, and the incidence of adverse events.
In a state of rest and cough, patients in the Group TP showed significantly lower VAS pain scores at 1, 12, 24, and 48 postoperative-hour compared with Group C and Group T. Intraoperative sufentanil and postoperative oxycodone consumption, the first time to press analgesic pump, the times of effective and total compressions of patient- controlled analgesia (PCA) were lower than those of the Group C and Group T. Interestingly, urine output was higher in Group TP. There were no differences between the three groups in terms of extubation time, length of hospital stay and adverse effects, indicating that intravenous paracetamol and mannitol injection is an effective and safe perioperative analgesia method.
Paracetamol and mannitol injection, combined with TPVB may provide important beneficial effects on acute pain control and reduce the consumption of opioid in patients undergoing VATS.
The trial was registered on Jun 19, 2023 in the Chinese Clinical Trial Registry ( https://www.chictr.org.cn/showproj.html?proj=199315 ), registration number ChiCTR2300072623 (19/06/2023).
This study was a single-center, prospective, randomized, double-blind controlled clinical trial. Patients scheduled for VATS were randomly divided into three groups, general anesthesia group (Group C), TPVB group (Group T) and TPVB + paracetamol and mannitol injection group (Group TP). In this study, the primary outcome was determined as visual analog scale (VAS) scores at rest and coughing, the secondary observation outcomes were the first time to use analgesic pump, the total consumption of oxycodone in the analgesic pump, number of effective and total analgesic pump compressions at first 48 h postoperatively, the perioperative consumption of sufentanil, time to extubation, hospital length of stay, urine volume, and the incidence of adverse events.
In a state of rest and cough, patients in the Group TP showed significantly lower VAS pain scores at 1, 12, 24, and 48 postoperative-hour compared with Group C and Group T. Intraoperative sufentanil and postoperative oxycodone consumption, the first time to press analgesic pump, the times of effective and total compressions of patient- controlled analgesia (PCA) were lower than those of the Group C and Group T. Interestingly, urine output was higher in Group TP. There were no differences between the three groups in terms of extubation time, length of hospital stay and adverse effects, indicating that intravenous paracetamol and mannitol injection is an effective and safe perioperative analgesia method.
Paracetamol and mannitol injection, combined with TPVB may provide important beneficial effects on acute pain control and reduce the consumption of opioid in patients undergoing VATS.
The trial was registered on Jun 19, 2023 in the Chinese Clinical Trial Registry ( https://www.chictr.org.cn/showproj.html?proj=199315 ), registration number ChiCTR2300072623 (19/06/2023).
摘要：
背景：尽管电视胸腔镜手术（VATS）具有减少伤害和更快愈合的优点，患者仍然忍受中度和重度术后疼痛。扑热息痛和甘露醇注射液，中国首个对乙酰氨基酚注射液，具有管理方便的优点，迅速开始行动，没有第一遍效果。这项研究的目的是探讨对乙酰氨基酚和甘露醇注射术后镇痛的疗效。联合胸椎旁神经阻滞（TPVB）治疗VATS术后疼痛。
方法：本研究是单中心，prospective,随机化，双盲对照临床试验。将预定接受VATS的患者随机分为三组，全身麻醉组(C组),TPVB组(T组)和TPVB+扑热息痛+甘露醇打针组(TP组)。在这项研究中,主要结局以静息和咳嗽时的视觉模拟量表（VAS）评分确定，次要观察结果是首次使用镇痛泵，镇痛泵中羟考酮的总消耗量，术后第48小时有效和完全镇痛泵按压次数，围手术期服用舒芬太尼，拔管时间，住院时间,尿量,以及不良事件的发生率。
结果：在休息和咳嗽的状态下，与C组和T组相比，TP组患者在术后1、12、24和48小时的VAS疼痛评分显着降低。第一次按下镇痛泵，患者自控镇痛（PCA）的有效和完全按压次数低于C组和T组。TP组尿量较高.三组拔管时间无差异,住院时间和不良反应，提示对乙酰氨基酚和甘露醇静脉注射是一种安全有效的围手术期镇痛方法。
结论：扑热息痛和甘露醇注射液，联合TPVB可能对VATS患者的急性疼痛控制提供重要的有益效果，并减少阿片类药物的消耗。
背景：该试验于2023年6月19日在中国临床试验注册中心注册（https://www.chictr.org.cn/showproj.html?proj=199315),注册号ChiCTR2300072623（19/06/2023）。
方法：本研究是单中心，prospective,随机化，双盲对照临床试验。将预定接受VATS的患者随机分为三组，全身麻醉组(C组),TPVB组(T组)和TPVB+扑热息痛+甘露醇打针组(TP组)。在这项研究中,主要结局以静息和咳嗽时的视觉模拟量表（VAS）评分确定，次要观察结果是首次使用镇痛泵，镇痛泵中羟考酮的总消耗量，术后第48小时有效和完全镇痛泵按压次数，围手术期服用舒芬太尼，拔管时间，住院时间,尿量,以及不良事件的发生率。
结果：在休息和咳嗽的状态下，与C组和T组相比，TP组患者在术后1、12、24和48小时的VAS疼痛评分显着降低。第一次按下镇痛泵，患者自控镇痛（PCA）的有效和完全按压次数低于C组和T组。TP组尿量较高.三组拔管时间无差异,住院时间和不良反应，提示对乙酰氨基酚和甘露醇静脉注射是一种安全有效的围手术期镇痛方法。
结论：扑热息痛和甘露醇注射液，联合TPVB可能对VATS患者的急性疼痛控制提供重要的有益效果，并减少阿片类药物的消耗。
背景：该试验于2023年6月19日在中国临床试验注册中心注册（https://www.chictr.org.cn/showproj.html?proj=199315),注册号ChiCTR2300072623（19/06/2023）。
