Clinical Analysis of Different Anesthesia and Analgesia Methods for Patients Undergoing Uniportal Video-assisted Lung Surgery

Abstract

PurposeA comparison of three intra-op modalities to determine a best and convenient pain control for uniportal lung surgery. This study compared general anesthesia with serratus plane block, general anesthesia with epidural and general anesthesia alone to look at post-operative pain scores in patients. Methods80 patients were enrolled and statistically analyzed. There were three interventions studied: Group S: General Anesthesia with Serratus Plane Block, Group E: General Anesthesia with thoracic epidural, Group G: General Anesthesia only. Outcome measures compared among 3 groups included demographic characters; surgical types; anesthesia and operative time; postoperative pain scores; vitals sign; morphine consumption at 0, 2, 6 hours, day1 and day2 postoperative; incidence of opioid-related adverse events and chronic pain; LOS hospital and overall expenses.The numerical rating scale was used to assess the degree of pain on the first and second postoperative days. Postoperative morphine consumption, incidence of opioid-related side effects, LOS(length of stay) hospital and overall hospital expenses were documented, as well as incidence of chronic postoperative pain. FindingsThere was no difference in incidence of opioid-related adverse events and chronic pain, LOS hospital and overall expenses among 3 groups. After investigating factors that may influence LOS hospital and overall expenses, the multivariable analysis indicated only longer operative time was associated with longer hospital stay and more hospital expenses. ImplicationsThis prospective study demonstrates that general anesthesia alone offers an easy and efficient approach resulting in similar postoperative pain scores and morphine consumption compared with nerve block and epidural. Longer operative time was associated with longer hospital stay and more hospital expenses.