Related Experiment Video
Updated: May 22, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Postoperative Analgesia and Length of Hospital Stay After Surgery for Malignant Pleural Mesothelioma: A Retrospective
Mayuu Kobata1, Kenta Takeda1, Mana Taguchi1
1Department of Anesthesiology, Hyogo Medical University Faculty of Medicine, Nishinomiya, Hyogo, Japan.
Background:
Pleurectomy/decortication (P/D), a surgical procedure for malignant pleural mesothelioma (MPM), is a highly invasive surgery requiring prolonged hospitalization. Previous studies have reported that postoperative analgesia using regional anesthesia contributes to shorter hospital stays after surgery under general anesthesia by reducing acute postoperative pain. However, the association between postoperative analgesia and the length of hospital stay (LOHS) following P/D has not been evaluated.
Objectives:
To evaluate the association between postoperative analgesia and postoperative LOHS after P/D.
Methods:
This single-institution observational study enrolled consecutive adult patients undergoing P/D under general anesthesia, who postoperatively received either intertransverse process block (ITPB) or continuous intravenous (IV) fentanyl infusion as postoperative analgesia between March 2022 and February 2023.
Results:
Among all enrolled patients with ASA physical status II or III (n = 60), postoperative analgesia was administered using either continuous ITPB (n = 19) or continuous IV fentanyl infusion (n = 41). Multivariable logistic regression analysis revealed that postoperative analgesia with continuous ITPB (P = 0.007), a lower incidence of major complications after surgery (P = 0.034), and female sex (P = 0.033) were significantly associated with a shorter postoperative LOHS. In subgroup analysis, patients who received continuous ITPB had significantly lower postoperative LOHS, lower postoperative serum C-reactive protein levels on postoperative day (POD) 3, and reduced acute postoperative pain on POD3 compared to those who received continuous IV fentanyl infusion.
Conclusions:
Postoperative analgesia using continuous ITPB appears to be associated with a reduction in LOHS following P/D for MPM under general anesthesia.
Insights
Continuous intertransverse process block (ITPB) regional anesthesia may reduce hospital stays for patients undergoing pleurectomy/decortication (P/D) surgery for malignant pleural mesothelioma. This approach also lowered pain and inflammation markers post-surgery.
Area of Science:
- Thoracic surgery
- Anesthesiology
- Oncology
Background:
- Pleurectomy/decortication (P/D) is a major surgery for malignant pleural mesothelioma (MPM) often leading to extended hospital stays.
- Regional anesthesia for postoperative pain management has been linked to shorter hospital stays in other surgical contexts.
- The specific impact of postoperative analgesia on length of hospital stay (LOHS) after P/D has not been previously investigated.
Purpose of the Study:
- To determine the association between different postoperative analgesia methods and LOHS after P/D surgery.
- To compare the effectiveness of continuous intertransverse process block (ITPB) versus continuous intravenous (IV) fentanyl infusion for pain management and recovery.
Main Methods:
- An observational study included adult patients undergoing P/D under general anesthesia.
- Patients received either continuous ITPB or continuous IV fentanyl infusion for postoperative analgesia.
- Multivariable logistic regression analysis was used to identify factors associated with shorter LOHS.
Main Results:
- Continuous ITPB was significantly associated with a shorter postoperative LOHS (P = 0.007).
- Lower major complication rates and female sex were also linked to reduced LOHS.
- Patients receiving ITPB showed lower LOHS, reduced C-reactive protein levels on postoperative day 3, and less pain on postoperative day 3 compared to IV fentanyl group.
Conclusions:
- Continuous ITPB as a postoperative analgesia strategy may decrease LOHS in patients undergoing P/D for MPM.
- ITPB demonstrates potential benefits in pain reduction and recovery acceleration post-thoracic surgery.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:30Endoscopic Studies I: Bronchoscopy and Thoracoscopy
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
01:30Pleural Disorders: Types and Brief Description
01:27Pneumothorax-II
Clinical Manifestations:
01:28Pleural Effusion II: Symptoms and Management
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease