Journal of thoracic disease
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Video-assisted thoracoscopic surgery (VATS) is a commonly performed minimally invasive procedure that has led to lower levels of pain, as well as procedure-related mortality and morbidity. However, VATS requires analgesia that blocks both visceral and somatic nerve fibers for more effective pain control. This randomized controlled trial evaluated the effect of erector spinae plane block (ESPB) in the postoperative analgesia management of patients undergoing VATS. ⋯ A single preoperative injection of ESPB with ropivacaine may improve acute postoperative analgesia and emergence agitation in patients undergoing VATS.
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Based on current evidence, vaccination is recommended against the influenza virus and pneumococcus to avoid serious acute exacerbations in patients with chronic obstructive pulmonary disease (COPD), but the rate of their vaccination coverage is still suboptimal. To determine the prevalence and effectiveness of influenza and pneumococcal vaccination in COPD patients, and to prove its hypothetical association with the decreasing number of acute exacerbations. ⋯ We found association between influenza and pneumococcal vaccination and the reduced risk of hospitalization due to exacerbations in the ensuing year. The prevalence of vaccination is significantly below the optimal level.