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Abstract：
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) often induces significant postoperative pain, potentially leading to chronic pain and decreased quality of life. This study aimed to evaluate the acetaminophen/ibuprofen combination effectiveness in reducing analgesic requirements and pain intensity in patients undergoing VATS.
METHODS: This is a double-blinded randomized controlled trial.
METHODS: Adult patients scheduled for elective VATS for lung resection were randomized to receive either intravenous acetaminophen and ibuprofen (intervention group) or 100 mL normal saline (control group). Treatments were administered post-anesthesia induction and every 6 h for three cycles. The primary outcome was total analgesic consumption at 24 h postoperatively. Secondary outcomes were cumulative analgesic consumption at 2 and 48 h; analgesic-related side effects at 2, 24, and 48 h; quality of recovery at 24 h and 48 h postoperatively; pain intensity at rest and during coughing; and rescue analgesics use. Chronic postsurgical pain (CPSP) was assessed through telephone interviews 3 months postoperatively.
RESULTS: The study included 96 participants. The intervention group showed significantly lower analgesic consumption at 24 h and 48 h postoperatively (24 h: median difference: - 100 µg equivalent intravenous fentanyl [95% confidence interval (CI) - 200 to - 5 μg], P = 0.037; 48 h: median difference: - 140 μg [95% CI - 320 to - 20 μg], P = 0.035). Compared to the controls, the intervention group exhibited a significantly lower quality of recovery 24 h post-surgery, with no significant difference at 48 h. All pain scores except for coughing at 48 h post-surgery were significantly lower in the intervention group compared to the controls. No significant differences were observed between the groups in postoperative nausea and vomiting occurrence, hospital stay length, and CPSP.
CONCLUSIONS: Perioperative administration of acetaminophen/ibuprofen significantly decreased analgesic needs in patients undergoing VATS, providing an effective postoperative pain management strategy, and potentially minimizing the need for stronger analgesics.
METHODS: This is a double-blinded randomized controlled trial.
METHODS: Adult patients scheduled for elective VATS for lung resection were randomized to receive either intravenous acetaminophen and ibuprofen (intervention group) or 100 mL normal saline (control group). Treatments were administered post-anesthesia induction and every 6 h for three cycles. The primary outcome was total analgesic consumption at 24 h postoperatively. Secondary outcomes were cumulative analgesic consumption at 2 and 48 h; analgesic-related side effects at 2, 24, and 48 h; quality of recovery at 24 h and 48 h postoperatively; pain intensity at rest and during coughing; and rescue analgesics use. Chronic postsurgical pain (CPSP) was assessed through telephone interviews 3 months postoperatively.
RESULTS: The study included 96 participants. The intervention group showed significantly lower analgesic consumption at 24 h and 48 h postoperatively (24 h: median difference: - 100 µg equivalent intravenous fentanyl [95% confidence interval (CI) - 200 to - 5 μg], P = 0.037; 48 h: median difference: - 140 μg [95% CI - 320 to - 20 μg], P = 0.035). Compared to the controls, the intervention group exhibited a significantly lower quality of recovery 24 h post-surgery, with no significant difference at 48 h. All pain scores except for coughing at 48 h post-surgery were significantly lower in the intervention group compared to the controls. No significant differences were observed between the groups in postoperative nausea and vomiting occurrence, hospital stay length, and CPSP.
CONCLUSIONS: Perioperative administration of acetaminophen/ibuprofen significantly decreased analgesic needs in patients undergoing VATS, providing an effective postoperative pain management strategy, and potentially minimizing the need for stronger analgesics.
摘要：
背景：电视胸腔镜手术（VATS）通常会引起明显的术后疼痛，可能导致慢性疼痛和生活质量下降。本研究旨在评估对乙酰氨基酚/布洛芬组合在降低VATS患者镇痛需求和疼痛强度方面的有效性。
方法：这是一项双盲随机对照试验。
方法：择期VATS肺切除术的成年患者随机接受对乙酰氨基酚和布洛芬（干预组）或100mL生理盐水（对照组）。在麻醉后诱导和每6h给予治疗,持续三个周期。主要结果是术后24小时的镇痛总消耗量。次要结局为2小时和48小时的累积镇痛药消耗量；2小时、24小时和48小时的镇痛药相关副作用；术后24小时和48小时的恢复质量；休息时和咳嗽时的疼痛强度；以及抢救镇痛药的使用。术后3个月通过电话访谈评估慢性术后疼痛（CPSP）。
结果：该研究包括96名参与者。干预组在术后24h和48h的镇痛药消耗量显着降低（24h：中位数差异：-100µg等效静脉注射芬太尼[95％置信区间（CI）-200至-5μg]，P=0.037；48小时：中位数差异：-140μg[95%CI-320至-20μg]，P=0.035)。与对照相比，干预组术后24小时恢复质量明显较低，与对照组相比，干预组术后48h除咳嗽外的所有疼痛评分均显着降低。两组患者术后恶心呕吐发生率差异无统计学意义,住院时间,和CPSP。
结论：围手术期给予对乙酰氨基酚/布洛芬显著降低了VATS患者的镇痛需求，提供有效的术后疼痛管理策略，并可能最大限度地减少对更强镇痛药的需求。
方法：这是一项双盲随机对照试验。
方法：择期VATS肺切除术的成年患者随机接受对乙酰氨基酚和布洛芬（干预组）或100mL生理盐水（对照组）。在麻醉后诱导和每6h给予治疗,持续三个周期。主要结果是术后24小时的镇痛总消耗量。次要结局为2小时和48小时的累积镇痛药消耗量；2小时、24小时和48小时的镇痛药相关副作用；术后24小时和48小时的恢复质量；休息时和咳嗽时的疼痛强度；以及抢救镇痛药的使用。术后3个月通过电话访谈评估慢性术后疼痛（CPSP）。
结果：该研究包括96名参与者。干预组在术后24h和48h的镇痛药消耗量显着降低（24h：中位数差异：-100µg等效静脉注射芬太尼[95％置信区间（CI）-200至-5μg]，P=0.037；48小时：中位数差异：-140μg[95%CI-320至-20μg]，P=0.035)。与对照相比，干预组术后24小时恢复质量明显较低，与对照组相比，干预组术后48h除咳嗽外的所有疼痛评分均显着降低。两组患者术后恶心呕吐发生率差异无统计学意义,住院时间,和CPSP。
结论：围手术期给予对乙酰氨基酚/布洛芬显著降低了VATS患者的镇痛需求，提供有效的术后疼痛管理策略，并可能最大限度地减少对更强镇痛药的需求。
