• Masui · Feb 2016

    [Postoperative Analgesia for Video-assisted Thoracoscopic Surgery--Continuous Intravenous Infusion of Fentanyl Combined with Intercostal Nerve Block v.s. Continuous Epidural Analgesia].

    • Kanako Hiro, Tomohiro Sugiyama, Masashi Kurata, Yumiko Oi, and Masahiro Okuda.
    • Masui. 2016 Feb 1; 65 (2): 114-8.

    BackgroundEpidural 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.MethodsForty-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).ConclusionsContinuous 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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