Video-Assisted thoracic surgery (VATS) is the standard treatment for localized lung cancer. However, there is no consensus on analgesic management in patients undergoing VATS. The aim of the study is to compare the analgesic efficacy of thoracic epidural with that a "Bi-block" combining an Erector Spinae muscle plane Block (ESP) and a Serratus Anterior Block (SAP) in patients undergoing VATS for lung or pleural surgery. Our main hypothesis is that the analgesic efficacy of the Bi-block, assessed by morphine consumption, is not inferior to that provided by a thoracic epidural during the first 48 hours after VATS. We conducted a age, gender and type of surgery-matched retrospective cohort study in the Department of Thoracic Anesthesia of the Montpellier University Hospital (France).
Study Type
OBSERVATIONAL
Enrollment
90
In the TEA group, a thoracic epidural was performed before VATS. In the Bi-block group, a SAP block associated with an ESP block were performed before surgical incision under general anesthesia.
Intensive Care Unit, D - University hospital of Montpellier
Montpellier, France
cumulative morphine consumption on postoperative day 2
cumulative morphine consumption on postoperative day 2, including the morphine administered in Post anesthesia care unit (PACU), on postoperative day 0, 1 and 2.
Time frame: postoperative day 2
non-opioid analgesics consumption on postoperative day 2
Paracetamol, Tramadol, Ketoprofen, Nefopam cumulative consumption on POD 2.
Time frame: postoperative day 2
Pain assessed by visual analog pain scale (VAS)
mean VAS, maximal VAS, number of events with a VAS \> 3
Time frame: up to postoperative day 2
Urinary retention
Time frame: up to postoperative day 2
hypotension
Time frame: up to postoperative day 2
pleural drain duration
Time frame: up to postoperative day 2
duration of hospitalization
Time frame: up to postoperative day 2
occurrence of prurit
Time frame: up to postoperative day 2
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