Analgesic drugs for patients with non-small cell lung cancer undergoing video-assisted thoracic surgery lobectomy: A randomized controlled trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIN Lin , JI Yanli ,  CHE Guowei , NIU Lingli , WANG Mingming , LI Xia , LIAO Hu , YANG Mei

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding?author：

CHE Guowei, Email: guowei_che@yahoo.com

Keywords：

Video-assisted thoracic surgery (VATS) lobectomy; parecoxib sodium; dezocine; lung cancer

DOI：

10.7507/1007-4848.201702021

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To clearly define and describe the difference of analgesic actions and side effects between dezocine and parecoxib sodium in video-assisted thoracic surgery (VATS) lobectomy. Methods Ninety patients underwent thoracotomy (lobectomy) and were hospitalized in the Department of Thoracic Surgery, West China Hospital, Sichuan University between August 2015 and January 2016. Patients were randomly divided into two groups including a parecoxib sodium group (a PG group, 43 patients) and a dezocine group (a DG group, 47 patients). We analyzed the occurrence of side effects in the two groups, as well as other outcomes including visual analogous scores and location of the pain et al. Results The occurrences of nausea, vomit and abdominal distention in the PG group (9.30%, 2.33%, 13.95%) were significantly lower than those of the DG group (25.53%, 17.02%, 40.43% , P=0.046, P=0.032, P=0.009) in the early period after operation. Pain scores at the postoperative 12 h, 24 h, 48 h and 72 h in the PG group (2.56±0.96, 2.47±0.96, 1.93±0.99, 0.98±1.24) were better than those of the DG group (4.00±1.60, 3.62±1.48, 3.36±1.55, 2.47±1.78,P=0.000, P=0.000, P=0.000, P=0.002). And the same results were found in the postoperative coughing VAS assessment. The mostly reported pain location was the chest drainage, incision site and chest wall in turn. Postoperative pain properties, in turn, were swelling, stabbing pain and numbness. Conclusion Postoperative pain after VATS lobectomy may be adequately controlled using parecoxib sodium. The low pain scores and decreased adverse effects are achieved.

Citation： LIN Lin, JI Yanli, CHE Guowei, NIU Lingli, WANG Mingming, LI Xia, LIAO Hu, YANG Mei. Analgesic drugs for patients with non-small cell lung cancer undergoing video-assisted thoracic surgery lobectomy: A randomized controlled trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(11): 830-834. doi: 10.7507/1007-4848.201702021 Copy

1.	車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
2.	Yang HC, Lee JY, Ahn S, et al.Pain control of thoracoscopic major pulmonary resection: is pre-emptive local bupivacaine injection able to replace the intravenous patient controlled analgesia? J Thorac Dis, 2015, 7(11): 1960-1969.
3.	Tsubokawa N, Harada H, Takenaka C, et al.Comparison of postoperative pain after different thoracic surgery approaches as measured by electrical dtimulation. Thorac Cardiovasc Surg, 2015, 63(6): 519-525.
4.	Akter F, Routledge T, Toufektzian L, et al.In minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery? Interact Cardiovasc Thorac Surg, 2015,20(4): 550-555.
5.	Liu L, Che G, Pu Q, et al.A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy.Surg Oncol, 2010, 19(2): 71-77.
6.	Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 12(1):3165-3181.
7.	韓兆杰, 宋志芳, 蘇建華, 等. 單胸腔引流管在肺癌術后快速康復中的應用. 中國胸心血管外科臨床雜志, 2014, 21(1): 17-20.
8.	楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后 16F 較 28F 胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
9.	周洪霞, 楊梅, 廖虎, 等. 胸腔鏡肺葉切除術后 16F 尿管胸腔引流可行性的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2016, 23(4): 334-340.
10.	鮑珊, 蘇建華, 廖虎, 等. 合并慢性阻塞性肺病和手術方式對肺癌患者術后快速康復及治療費用的影響. 中國胸心血管外科臨床雜志, 2014, 21(1): 17-20.
11.	McElnay PJ, Molyneux M, Krishnadas R, et al. Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study. Eur J Cardiothorac Surg, 2015, 47(5): 912-915.
12.	Du N, Rao Z, Che G, et al.What is result: short-term medium chain triglyceride diet effective on?postoperative outcome in lung cancer surgery? A prospective randomized study. Zhongguo Fei Ai Za Zh. 2016, 19(12):821-826.
13.	Kol E, Erdogan A, Karsl? B. Nature and intensity of the pain following thoracotomy. Int J Nurs Pract. 2012, 18(1):84-90.
14.	Xu Y, Zhu Y, Wang S, et al.Dezocine attenuates fentanyl-induced cough in a dose-dependent manner-a randomized controlled trial. Int J Clin Exp Med. 2015, 8(4): 6091-6096.
15.	車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.
16.	蘇建華, 周渝斌, 蒲強, 等. 影響肺癌手術住院費用和快速康復的臨床因素分析. 中國肺癌雜志, 2014, 17(7): 536-540.
17.	Cohen RI, Edwards WT, Kezer EA, et al. Serial intravenous doses of dezocine, morphine, and nalbuphine in the management of postoperative pain for outpatients. Anesth Analg, 1993, 77(3): 533-539.
18.	Fletcher D, Fermanian C, Mardaye A, et al. A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges. Pain. 2008, 137:441-451.
19.	Chen H, Luo A. Safety and efficacy study of the cyclooxygenase-2 inhibitor parecoxib sodium applied for postoperative analgesia after endo-nasal operation. Pain Pract, 2016, 16(4): 467-472.
20.	Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010, 13(11): 999-1003.

1. 車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
2. Yang HC, Lee JY, Ahn S, et al.Pain control of thoracoscopic major pulmonary resection: is pre-emptive local bupivacaine injection able to replace the intravenous patient controlled analgesia? J Thorac Dis, 2015, 7(11): 1960-1969.
3. Tsubokawa N, Harada H, Takenaka C, et al.Comparison of postoperative pain after different thoracic surgery approaches as measured by electrical dtimulation. Thorac Cardiovasc Surg, 2015, 63(6): 519-525.
4. Akter F, Routledge T, Toufektzian L, et al.In minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery? Interact Cardiovasc Thorac Surg, 2015,20(4): 550-555.
5. Liu L, Che G, Pu Q, et al.A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy.Surg Oncol, 2010, 19(2): 71-77.
6. Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 12(1):3165-3181.
7. 韓兆杰, 宋志芳, 蘇建華, 等. 單胸腔引流管在肺癌術后快速康復中的應用. 中國胸心血管外科臨床雜志, 2014, 21(1): 17-20.
8. 楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后 16F 較 28F 胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
9. 周洪霞, 楊梅, 廖虎, 等. 胸腔鏡肺葉切除術后 16F 尿管胸腔引流可行性的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2016, 23(4): 334-340.
10. 鮑珊, 蘇建華, 廖虎, 等. 合并慢性阻塞性肺病和手術方式對肺癌患者術后快速康復及治療費用的影響. 中國胸心血管外科臨床雜志, 2014, 21(1): 17-20.
11. McElnay PJ, Molyneux M, Krishnadas R, et al. Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study. Eur J Cardiothorac Surg, 2015, 47(5): 912-915.
12. Du N, Rao Z, Che G, et al.What is result: short-term medium chain triglyceride diet effective on?postoperative outcome in lung cancer surgery? A prospective randomized study. Zhongguo Fei Ai Za Zh. 2016, 19(12):821-826.
13. Kol E, Erdogan A, Karsl? B. Nature and intensity of the pain following thoracotomy. Int J Nurs Pract. 2012, 18(1):84-90.
14. Xu Y, Zhu Y, Wang S, et al.Dezocine attenuates fentanyl-induced cough in a dose-dependent manner-a randomized controlled trial. Int J Clin Exp Med. 2015, 8(4): 6091-6096.
15. 車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.
16. 蘇建華, 周渝斌, 蒲強, 等. 影響肺癌手術住院費用和快速康復的臨床因素分析. 中國肺癌雜志, 2014, 17(7): 536-540.
17. Cohen RI, Edwards WT, Kezer EA, et al. Serial intravenous doses of dezocine, morphine, and nalbuphine in the management of postoperative pain for outpatients. Anesth Analg, 1993, 77(3): 533-539.
18. Fletcher D, Fermanian C, Mardaye A, et al. A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges. Pain. 2008, 137:441-451.
19. Chen H, Luo A. Safety and efficacy study of the cyclooxygenase-2 inhibitor parecoxib sodium applied for postoperative analgesia after endo-nasal operation. Pain Pract, 2016, 16(4): 467-472.
20. Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010, 13(11): 999-1003.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analgesic drugs for patients with non-small cell lung cancer undergoing video-assisted thoracic surgery lobectomy: A randomized controlled trial

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