Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trial
Abstract Background Various analgesic techniques have been applied, the pain after video assisted thoracic surgery (VATS) is still challenging for anesthesiologists. Paracetamol provide analgesic efficacy in many surgeries. However, clinical evidence in the lung surgery with regional block remain li...
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BMC
2025-01-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-02888-4 |
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| author | Sujin Kim Seung Woo Song Haesung Lee Chun Sung Byun Ji-Hyoung Park |
| author_facet | Sujin Kim Seung Woo Song Haesung Lee Chun Sung Byun Ji-Hyoung Park |
| author_sort | Sujin Kim |
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| description | Abstract Background Various analgesic techniques have been applied, the pain after video assisted thoracic surgery (VATS) is still challenging for anesthesiologists. Paracetamol provide analgesic efficacy in many surgeries. However, clinical evidence in the lung surgery with regional block remain limited. This monocentric double-blind randomized controlled trial investigates the efficacy of paracetamol after VATS with regional block. Methods A total of 90 patients were randomized to receive paracetamol (1 g) or normal saline. Erector Spinae Plane Block and Intercostal Nerve block were applied during the surgery. The Visual Analogue Scales (VAS) pain score was measured in the PACU as well as 6, 12, 24, and 48 h postoperatively. And the total dose of rescue analgesics administered to patients in morphine milligram equivalents (MME), satisfaction score, length of hospital stays, and incidence of nausea and vomiting were also recorded. Results The VAS pain score at each time point, the primary endpoint, did not differ between the groups (3.09 ± 2.14 vs. 2.53 ± 1.67, p = 0.174 at PACU; 4.56 ± 2.80 vs. 4.06 ± 2.46, p = 0.368 at 6 h; 3.07 ± 1.98 vs. 3.44 ± 2.48, p = 0.427 at 12 h; 2.10 ± 2.00 vs. 2.49 ± 2.07, p = 0.368 at 24 h; and 1.93 ± 1.76 vs. 2.39 ± 1.97, p = 0.251 at 48 h postoperatively). Satisfaction scores (4.37 ± 0.76 vs. 4.14 ± 0.88, p = 0.201), nausea (35.6% vs. 37.8%, p = 0.827), hypotension (2.2% vs. 0.0%, p = 0.317), and bradycardia (6.7% vs. 2.2%, p = 0.309) were also reported at similar rates. Conclusions The analgesic efficacy of one gram of paracetamol with ESPB and ICNB after VATS was not proven. Thus, caution should be exercised when prescribing paracetamol for pain control during VATS. Trial registration this trial was registered on Clinical Research Information Service (CRIS), Republic of Korea (KCT0008710). Registration date: 17/08/2023. |
| format | Article |
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| institution | Kabale University |
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| spelling | doaj-art-1e55b4a9a0274266ad6d6c0b30cda64f2025-01-12T12:37:00ZengBMCBMC Anesthesiology1471-22532025-01-012511710.1186/s12871-025-02888-4Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trialSujin Kim0Seung Woo Song1Haesung Lee2Chun Sung Byun3Ji-Hyoung Park4Department of Anesthesiology and Pain Medicine, Wonju College of Medicine, Yonsei UniversityDepartment of Anesthesiology and Pain Medicine, Wonju College of Medicine, Yonsei UniversityDepartment of Anesthesiology and Pain Medicine, Wonju College of Medicine, Yonsei UniversityDepartment of Thoracic and Cardiovascular Surgery, Wonju College of Medicine, Yonsei UniversityDepartment of Anesthesiology and Pain Medicine, Wonju College of Medicine, Yonsei UniversityAbstract Background Various analgesic techniques have been applied, the pain after video assisted thoracic surgery (VATS) is still challenging for anesthesiologists. Paracetamol provide analgesic efficacy in many surgeries. However, clinical evidence in the lung surgery with regional block remain limited. This monocentric double-blind randomized controlled trial investigates the efficacy of paracetamol after VATS with regional block. Methods A total of 90 patients were randomized to receive paracetamol (1 g) or normal saline. Erector Spinae Plane Block and Intercostal Nerve block were applied during the surgery. The Visual Analogue Scales (VAS) pain score was measured in the PACU as well as 6, 12, 24, and 48 h postoperatively. And the total dose of rescue analgesics administered to patients in morphine milligram equivalents (MME), satisfaction score, length of hospital stays, and incidence of nausea and vomiting were also recorded. Results The VAS pain score at each time point, the primary endpoint, did not differ between the groups (3.09 ± 2.14 vs. 2.53 ± 1.67, p = 0.174 at PACU; 4.56 ± 2.80 vs. 4.06 ± 2.46, p = 0.368 at 6 h; 3.07 ± 1.98 vs. 3.44 ± 2.48, p = 0.427 at 12 h; 2.10 ± 2.00 vs. 2.49 ± 2.07, p = 0.368 at 24 h; and 1.93 ± 1.76 vs. 2.39 ± 1.97, p = 0.251 at 48 h postoperatively). Satisfaction scores (4.37 ± 0.76 vs. 4.14 ± 0.88, p = 0.201), nausea (35.6% vs. 37.8%, p = 0.827), hypotension (2.2% vs. 0.0%, p = 0.317), and bradycardia (6.7% vs. 2.2%, p = 0.309) were also reported at similar rates. Conclusions The analgesic efficacy of one gram of paracetamol with ESPB and ICNB after VATS was not proven. Thus, caution should be exercised when prescribing paracetamol for pain control during VATS. Trial registration this trial was registered on Clinical Research Information Service (CRIS), Republic of Korea (KCT0008710). Registration date: 17/08/2023.https://doi.org/10.1186/s12871-025-02888-4ParacetamolVideo assisted thoracic surgeryErector spinae plane blockIntercostal nerve blockAnalgesic efficacyVisual analogue scales |
| spellingShingle | Sujin Kim Seung Woo Song Haesung Lee Chun Sung Byun Ji-Hyoung Park Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trial BMC Anesthesiology Paracetamol Video assisted thoracic surgery Erector spinae plane block Intercostal nerve block Analgesic efficacy Visual analogue scales |
| title | Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trial |
| title_full | Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trial |
| title_fullStr | Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trial |
| title_full_unstemmed | Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trial |
| title_short | Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trial |
| title_sort | paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery a randomized controlled trial |
| topic | Paracetamol Video assisted thoracic surgery Erector spinae plane block Intercostal nerve block Analgesic efficacy Visual analogue scales |
| url | https://doi.org/10.1186/s12871-025-02888-4 |
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