초록접수 현황
| 16F-224 | 구연 발표 |
Prospective Randomized Trial Comparing the Effectiveness of Continuous Paravertebral Infusion of Local Anesthetics Versus Intravenous Patient-controlled Analgesia on Acute and Chronic Neuropathic Pain after Thoracoscopic Lobectomy
Kyoung Shik Narm, Seokkee Lee, Jee Won Suh, Chang Young Lee, Jin Gu Lee, Hyo Char Paik, Kyung Young Chung, Dae Joon Kim
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : Continuous subpleural infusion of local anesthetics (On-Q system) has known as equivalent option for pain control compared to traditional method after thoracic surgery. In this study, we investigated the effectiveness of continuous paravertebral infusion of local anesthetics compared to intravenous patient-controlled analgesia (IV-PCA) to control acute and chronic neuropathic pain followed by thoracoscopic lobectomy
Methods : The study was designed as a prospective randomized trial(ClinicalTrials.gov ID: NCT01703351). 59 patients were recruited into the study from October 2012 to July 2015. On-Q catheter was placed below parietal pleura at the end of the operation and was maintained for 60 hours. Early postoperative pain was measured with a visual analog scale (VAS) and use of additional injection of opioid analgesics. During 6 months follow up, pain was serially measured by VAS and quantitative sensory test (QST). Quality of life (QOL, using EORTC-QLQ C30-LC13) was assessed at the same time
Results : There was no significant difference between two groups in baseline patient characteristics. In the early postoperative period, On-Q group showed significant higher VAS score and needed more additional injection of opioid analgesics. Side effects and resultant disconnection of device occurred more in IV-PCA group but didn’t show significant difference. During follow up period, VAS didn’t show significant difference between two groups. As to QST, hypoesthesia to cool, temporal summation to monofilament and threshold for tactile stimuli didn’t show significant difference between groups. Side-to-side difference between operated wound and non-operated chest for heat pain threshold was more increased in IV-PCA group (3.52±3.61 vs. -0.14±2.24, p=0.0459). QOL didn’t show significant difference between groups except that On-Q group showed higher chest pain scale (19.7±19.0 vs. 10.4±15.6, p=0.048)
Conclusion : For acute pain, On-Q didn’t show equivalent effect compared to IV-PCA. Most parameter for chronic pain including VAS, QST and QOL didn’t show significant difference between two groups
Methods : The study was designed as a prospective randomized trial(ClinicalTrials.gov ID: NCT01703351). 59 patients were recruited into the study from October 2012 to July 2015. On-Q catheter was placed below parietal pleura at the end of the operation and was maintained for 60 hours. Early postoperative pain was measured with a visual analog scale (VAS) and use of additional injection of opioid analgesics. During 6 months follow up, pain was serially measured by VAS and quantitative sensory test (QST). Quality of life (QOL, using EORTC-QLQ C30-LC13) was assessed at the same time
Results : There was no significant difference between two groups in baseline patient characteristics. In the early postoperative period, On-Q group showed significant higher VAS score and needed more additional injection of opioid analgesics. Side effects and resultant disconnection of device occurred more in IV-PCA group but didn’t show significant difference. During follow up period, VAS didn’t show significant difference between two groups. As to QST, hypoesthesia to cool, temporal summation to monofilament and threshold for tactile stimuli didn’t show significant difference between groups. Side-to-side difference between operated wound and non-operated chest for heat pain threshold was more increased in IV-PCA group (3.52±3.61 vs. -0.14±2.24, p=0.0459). QOL didn’t show significant difference between groups except that On-Q group showed higher chest pain scale (19.7±19.0 vs. 10.4±15.6, p=0.048)
Conclusion : For acute pain, On-Q didn’t show equivalent effect compared to IV-PCA. Most parameter for chronic pain including VAS, QST and QOL didn’t show significant difference between two groups
첨부파일 : ON Q 초록2 table.docx
책임저자: Dae Joon Kim
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Kyoung Shik Narm, E-mail : cardiosur@yuhs.ac