Evaluation of the effectiveness of Continuous Infusion Pump (CIP) in pain control in the recovery period after thoracic surgery

Authors

DOI:

https://doi.org/10.33448/rsd-v11i13.35727

Keywords:

Thoracotomy, Pain, Anesthesia, epidural, Infusion Pumps.

Abstract

Objective: to verify the effectiveness of epidural block in a continuous infusion pump (BIC), without pain control in the postoperative period of thoracic surgery. Methodology: cross-sectional study, using a database carried out at the Center for Oncological Research (CEPON), in patients undergoing thoracic surgery from 2018 to 2020, in patients undergoing a thoracotomy. For data analysis, the IBM Statististicsl Package for the Social Sciences (IBM SPSS®) 18.0 program was used, in the descriptive analysis of the dependent variable Visual Analog Scale of Pain and Length of Stay in the ICU, using the Mann-Whitney U Test . Quantitative data generated by measures of central tendency (average) and their variability/dispersion and qualitative measures in the form of simple and relative frequencies. Study approved by the research ethics committee. Results: in this series, they were due to 35 patients who underwent thoracic surgery, the most prevalent male (57.1%), mean age 56.63 and mean ICU length of 2.78. The most frequent surgery for lobectomy (51.7%). The Mann-Whitney U Test leaves group 1 reporting less pain than group 2 at POi (p = 0.035). an average length of stay in the ICU was observed for patients in group 1 (3.67 ± 1.63). Conclusion: the study, the use of epidural block in BIC with superior efficacy in controlling postoperative pain in the sample undergoing thoracic surgery at CEPON, also observed a longer length of stay in the ICU of patients who used this anesthetic modality.

Author Biographies

  • Mayra Mejía Suárez, Centro de Pesquisas Oncológicas

    MD, Médica Anestesiologista

  • Fabiana Oenning da Gama, Universidade do Sul de Santa Catarina, Brasil

    Professora do Curso de Medicina UNISUL Pedra Branca, Enfermeira pós-graduada em Emergência e Terapia Intensiva

  • Vinicius Heurich, Centro de Pesquisas Oncológicas

    MD, Médico Anestesiologista

References

Almeida V., Gama E., Espejo C., & Pedroso J. (2018). A singularidade da dor de pacientes oncológicos em cuidados paliativos. Mudanças - Psicologia da Saúde, 26(1):75.

Appleton S. (2018). Dor Crónica Pós-Cirúrgica: Uma Realidade Crescente. Revista da Sociedade Portuguesa de Anestesiologia, 27(2).

Attri J., Kaur R., Kaur H., & Makhni R. (2016). Post thoracotomy pain management: A review of current available modalities. Department of Anaesthesia, Government Medical College,1(1).

Chen L., Wu Y., Cai Y., Ye Y., Li L., & Xia Y. (2019). Comparison of programmed intermittent bolus infusion and continuous infusion for postoperative patient-controlled analgesia with thoracic paravertebral block catheter: a randomized, double-blind, controlled trial. Regional Anesthesia & Pain Medicine, 44(2):240-245.

Dângelo, J. G. & Fattini, C.A. (2001). Anatomia Humana Sistêmica e Segmentar. (2a ed.), Atheneu.

Ercolani, D., Hopf, L.B.D.S., & Schwan, L. (2018). Dor crônica oncológica: avaliação e manejo. Acta medica, 39(2).

Gasparini, J., Mello, S., Marques, R., & Saraiva, R. (2008). Analgesia pós-operatória plexular contínua: estudo dos efeitos colaterais e do risco de infecção dos cateteres. Revista Brasileira de Anestesiologia, 58(6):602-613.

Goto, T. (2018) What is the best pain control after thoracic surgery? Journal of Thoracic Disease, 10(3):1335-1338.

Guyatt, G., Gutterman, D., Baumann, M., Addrizzo-Harris, D., Hylek, E., & Phillips, B. (2006) Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines. Chest, 129(1):174-181.

Heck, J. (2004) Anestesia em cirurgia torácica. Anestesiologia Princípios e Técnicas, 3:775-787.

Hall Burton, D., Boretsky, K. (2014) A comparison of paravertebral nerve block catheters and thoracic epidural catheters for postoperative analgesia following the Nuss procedure for pectus excavatum repair. Pediatric Anesthesia, 24(5):516-520.

Higashi, M., Shigematsu, K., Nakamori, E., Sakurai, S., & Yamaura, K. (2019) Efficacy of programmed intermittent bolus epidural analgesia in thoracic surgery: a randomized controlled trial. BMC Anesthesiology, 19(1).

Huang, A., & Sakata, R. (2016). Dor após esternotomia – revisão. Brazilian Journal of Anesthesiology, 66(4):395-401.

Instituto Nacional de Câncer José Alencar Gomes da Silva. (2015). Estimativa 2016: incidência de câncer no Brasil. Rio de Janeiro: INCA.

Julius, D., & Basbaum, A. (2001) Molecular mechanisms of nociception. Nature, 413(6852):203-210.

Kambam, J., Hammon, J., Parris, W., & Lupinetti, F. (1989) Intrapleural analgesia for postthoracotomy pain and blood levels of bupivacaine following intrapleural injection. Canadian Journal of Anaesthesia, 36(2):106-109.

Leandro, J., Rodrigues, O., Slaets, A., Schmidt, Jr. A., & Yaekashi, M. (2014). Comparação entre duas técnicas de fechamento de toracotomia: dor pós-operatória e função pulmonar. Jornal Brasileiro de Pneumologia,40(4).

Litle, V., & Canelli, R. (2020). Perioperative Management of the Thoracic Surgery Patient. Thoracic Surgery Clinics, 30(3)

Liu, F. F., Liu, X. M., Liu, X. Y., Tang, J., Jin, L., Li, W. Y., & Zhang, L. D. (2015). Postoperative continuous wound infusion of ropivacaine has comparable analgesic effects and fewer complications as compared to traditional patient-controlled analgesia with sufentanil in patients undergoing non-cardiac thoracotomy. Int J Clin Exp Med. 8(4):5438-45.

Loop, T., Harris, S., & Grimm, A. (2014) Recent Advances in Postoperative Pain Therapy for Thoracic Surgery. Current Anesthesiology Reports, 4(2):177-187.

Loftus, D. P., Elder, C., Russell, K., Spanos, S., Barnhart, D., & Scaife, E. (2016) Paravertebral regional blocks decrease length of stay following surgery for pe-

ctus excavatum in children. Journal of Pediatric Surgery, 51(1):149-153.

Mesbah, A., Yeung, J., & Gao, F. (2016). Pain after thoracotomy. BJA Education, 16(1):1-7.

Nicastri, D., Wisnivesky, J., Litle, V., Yun, J., Chin, C., & Dembitzer, F. (2008). Thoracoscopic lobectomy: Report on safety, discharge independence, pain, and chemotherapy tolerance. The Journal of Thoracic and Cardiovascular Surgery, 135(3):642-647.

Oram, R., & Rasburn, N. Analgesia for thoracic surgery. (2017). Anaesthesia & Intensive Care Medicine.;18(12):606-608.

Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. UFSM.

Ravindra, G. (2016). Intrapleural Analgesis for Post Thoractomy Pain Management. International Journal of Contemporary Medical Research, 3(10):2898-2902.

Resende, F., Mourão, M., Allevato, B., Oliveira, B., Oliveira, C., & Silva, S. (2014) Analgesia for thoracotomy with multi-perforated catheters and elastomeric pump: case report. Revista Médica de Minas Gerais, 24.

Rizzi, A., Raveglia, F., Scarci, M., Cioffi, U., & Baisi, A. (2019). The best strategy to control pain after thoracic surgery: multimodal strategy against pain. Video-Assisted Thoracic Surgery, 4:26-26.

Stroud, A., Tulanont, D., Coates, T., Goodney, P., & Croitoru, D. (2014). Epidural analgesia versus intravenous patient-controlled analgesia following minimally invasive pectus excavatum repair: a systematic review and meta-analysis. Journal of Pediatric Surgery, 49(5):798-806.

Summers, R., Agarwal, S., & Johnston, C. (2020). Cardiac and Thoracic surgery chapter, The Royal College of Anaesthetists, (4th ed.), 13: 391-411

Suzuki, K., Saji, H., Aokage, K., Watanabe, S., Okada, M., & Mizusawa, J. (2019). Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. The Journal of Thoracic and Cardiovascular Surgery, 158(3):895-907.

Tomaszek, L., Fenikowski, D., Gawron, D., & Komotajtys, H. (2019) Comparative efficacy of continuous infusion of bupivacaine/fentanyl and ropivacaine/fentanyl for paediatric pain control after the Ravitch procedure and thoracotomy. A prospective randomized study. Biomedical Papers, 163(4):366-373.

Westphal F. (2019). Avaliação Invasiva do Mediastino. Cuidados Padronizados em Dreno de Tórax Tecnicas e Manejo., 12.2:184-190.

World Health Organization - WHO. (2015). International Agency for research on cancer (IARC). http:// epic.iarc.fr/research/cancerworkinggroups/lungcancer.php.

.

Published

2022-10-11

Issue

Section

Review Article

How to Cite

Evaluation of the effectiveness of Continuous Infusion Pump (CIP) in pain control in the recovery period after thoracic surgery. Research, Society and Development, [S. l.], v. 11, n. 13, p. e412111335727, 2022. DOI: 10.33448/rsd-v11i13.35727. Disponível em: https://rsdjournal.org/rsd/article/view/35727. Acesso em: 5 dec. 2025.