Journal of thoracic disease
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Continuous thoracic epidural analgesia (TEA) is a preferred method of postoperative analgesia in thoracic surgery. Intravenous patient-controlled analgesia (IVPCA) may be an effective alternative. One of the most commonly used opioids in PCA is morphine. It has high antinociceptive efficacy but is associated with many adverse events. Oxycodone can be an alternative. A small number of scientific reports comparing morphine and oxycodone in PCA for the treatment of acute postoperative pain after thoracotomy was the reason to conduct this study. ⋯ TEA provided superior anaesthesia compared to PCA in our study group. Use of PCA oxycodone in postoperative pain management after open thoracotomy provides similar nociception control compared to morphine but is associated with less sedation and patients using oxycodone IVPCA require smaller doses of rescue analgesia compared to systemic morphine IVPCA.
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Diagnosis of sleep-disordered breathing (SDB) requires overnight polysomnography (PSG). Because of the cost and low availability of these procedures, the NoSAS score was developed to identify subjects at high risk of SDB. To evaluate the clinical utility of the NoSAS score for screening patients with SDB in China and to compare the predictive value of the NoSAS score with the Epworth Sleepiness Scale (ESS), we used the STOP-Bang questionnaire and the Berlin questionnaire. ⋯ The NoSAS score and the Berlin questionnaire both exhibited good predictive value for SDB patients. NoSAS is a more suitable questionnaire to use in clinic for the conveniences but the similar performance with another questionnaire.
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The incidence and risk factors of chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary embolism (PE) were still controversial. A systematic review and meta-analysis was conducted to assess the incidence and risk factors of CTEPH after acute PE. ⋯ CTEPH is not a rare complication of acute PE. Close follow-up and implementation of a comprehensive screening program are important, especially in patients with independent risk factors.