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Master Thesis

Comparaison de la qualité analgésique péri-opératoire entre le bloc serratus et para-vertébral dans la chirurgie thoracique vidéo-assistée : étude rétrospective

Abstract : Introduction: there is currently no gold standard for pain management in video-assisted thoracic surgery. Few studies have compared the serratus block with other reference technique such as paravertebral block (PVB). This study compares the postoperative morphine consumption between serratus and paravertebral block in patients operated by thoracoscopy. Material and method: we retrospectively analyzed 82 patients between december 2018 and june 2019 in the thoracic surgery department of Nice. The patients were divided into 2 groups: 41 in the paravertebral group and 41 in the serratus group. The primary endpoint was total oxycodone consumption at the end of the 48th postoperative hour (H48). The secondary outcomes were the pain scores with the Numeric Rating Scale (NRS), the per and post-operative analgesic consumption and the adverse effects of the blocks. Results: there was no difference in the total dose of oxycodone at H48 between the PVB group and serratus group (respectively, 15.6 vs 19.2 mg, p = 0.42). The median NRS were higher in the post-anesthesia care unit (PACU) and at postoperative day 1 in the serratus group (respectively 3.56 vs 5.42, p <0.01 and 2.76 vs 3.85, p = 0.03). The PACU morphine titration in mg / kg and the tramadol consumption at H48 were greater in the serratus group than PVB (respectively 0.08 vs 0.05 mg / kg, p = 0.04, 471 vs 375 mg, p = 0.04). No difference were found between the 2 groups on the total dose of oxycodone at the end of the first postoperative day, the intraoperative dose of remifentanil, the analgesics in PACU or the adverse effects of the blocks. Conclusion: this study suggests that the serratus block compared to BPV in video-assisted thoracic surgery is equivalent in terms of total oxycodone consumption at the 48th postoperative hour. A randomized controlled trial is needed to determine the place that should be given to the serratus block in the management of postoperative pain in video-thoracoscopy.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02386424
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Friday, November 29, 2019 - 12:13:36 PM
Last modification on : Wednesday, October 14, 2020 - 4:23:21 AM

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Luc Facchino. Comparaison de la qualité analgésique péri-opératoire entre le bloc serratus et para-vertébral dans la chirurgie thoracique vidéo-assistée : étude rétrospective. Médecine humaine et pathologie. 2019. ⟨dumas-02386424⟩

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