Application of wireless analgesic system in pain management after thoracoscopic lung resection: A retrospective cohort study with large sample_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GUO Jiaqi , MIAO Qing , ZHANG Yunyun , ZHANG Xiaofeng , CHEN Xu ,  WU Jingxiang

Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200030, P. R. China;

Corresponding author：

WU Jingxiang, Email: wjx1132@163.com

Keywords：

Wireless analgesia system; intravenous analgesia administration; postoperative pain management

DOI：

10.7507/1007-4848.202112089

Video：

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Objective To investigate the effect of intravenous analgesia with a wireless or traditional analgesia pump system in thoracoscopic lung resection.Methods Patients who used the patient-controlled intravenous analgesia after thoracoscopic lung resection between June 2016 and June 2021 were enrolled in the study. They were allocated into a wireless pump group (a ZigBee-based wireless analgesia pump system collecting data automatically) and a traditional analgesia pump group. Perioperative analgesia management followed the routine standard operation protocol of Shanghai Chest Hospital. The patients’ numeric rating scale (NRS) for pain and postoperative nausea and vomiting (PONV) scores were collected for analysis from the Anesthesia Information Record System. The incidence of postoperative analgesia insufficiency (defined as NRS≥4 points) within 48 h, the incidence of PONV within 24 h, and the 48 h completion rate of analgesia pump infusion were compared. Results A total of 59431 patients were collected, including 24855 males and 34576 females, 17209 patients in the wireless pump group, and 42222 patients in the traditional analgesia pump group. The incidence of analgesia insufficiency within 48 h after operation (3.75% vs. 4.98%, P=0.007), the incidence of PONV within 24 h after operation (13.60% vs. 16.70%, P=0.030) in the wireless pump group were lower than those in the traditional analgesia pump group. The 48 h completion rate of analgesia pump infusion in the wireless pump group was higher than that in the traditional analgesia pump group (83.40% vs. 71.90%, P<0.001). The wireless pump group could monitor the pressing times and use of the analgesia pump, while the traditional analgesia pump group could not record the relevant data. Conclusion Compared with the traditional analgesia pump, the wireless analgesia management system may be convenient for timely, accurate and individualized management, and has good analgesic effect and low incidence of adverse reactions, and may be more suitable for perioperative analgesia management.

Citation： GUO Jiaqi, MIAO Qing, ZHANG Yunyun, ZHANG Xiaofeng, CHEN Xu, WU Jingxiang. Application of wireless analgesic system in pain management after thoracoscopic lung resection: A retrospective cohort study with large sample. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(6): 873-878. doi: 10.7507/1007-4848.202112089 Copy

1.	Wei W, Zheng X, Gu Y, et al. Effect of general anesthesia with thoracic paravertebral block on postoperative delirium in elderly patients undergoing thoracoscopic lobectomy: A randomized-controlled trial. BMC Anesthesiol, 2022, 22(1): 1.
2.	Morlion B, Schäfer M, Betteridge N, et al. Non-invasive patient-controlled analgesia in the management of acute postoperative pain in the hospital setting. Curr Med Res Opin, 2018, 34(7): 1179-1186.
3.	Xing X, Bai Y, Sun K, et al. Single nucleotide polymorphisms associated with postoperative inadequate analgesia after single-port VATS in Chinese population. BMC Anesthesiol, 2020, 20(1): 38.
4.	Wang R, Wang S, Duan N, et al. From Patient-controlled analgesia to artificial intelligence-assisted patient-controlled analgesia: Practices and perspectives. Front Med (Lausanne), 2020, 7: 145.
5.	陈烨, 王迪, 刘敏, 等. 临床智能化疼痛管理的研究进展. 中华麻醉学杂志, 2020, 40(11): 1405-1408.
6.	Bhattarai R, Hamal PK. Comparison of fentanyl-propofol and ketamine-propofol combination in induction and maintenance with intravenous anesthesia for short surgical procedures at moderate elevations. J Nepal Health Res Counc, 2021, 18(4): 769-775.
7.	Lee A, Seyednejad N, Lawati YA, et al. Evolution of process and outcome measures during an enhanced recovery after thoracic surgery program. J Chest Surg, 2022, 55(2): 118-125.
8.	Komatsu R, Nash M, Peperzak KA, et al. Comparison between preoperative methadone and buprenorphine use on postoperative opioid requirement: A retrospective cohort study. Clin J Pain, 2022, 38(5): 311-319.
9.	Kutlu Yalcin E, Kim D, Mao G, et al. Effect of intraoperative subhypnotic infusion of propofol on postoperative nausea and vomiting: A retrospective analysis. J Clin Anesth, 2022, 78: 110672.
10.	Chen J, Luo Q, Huang S, et al. Effect of opioid-free anesthesia on postoperative analgesia after laparoscopic gynecologic surgery. Minerva Anestesiol, 2022, 88(6): 439-447.
11.	何君君. 成人术后静脉镇痛的历史及进展. 医学临床研究, 2019, 36(12): 2381-2383.
12.	杨秋红, 张益维, 黄长顺. 无线远程监控镇痛泵与普通镇痛泵系统临床应用效果比较. 浙江医学, 2018, 40(16): 1847-1849, 1854.
13.	Ulger G, Baldemir R. Comparison of patient-controlled analgesia with tramadol or morphine after video-assisted thoracoscopic surgery in geriatric patients. Cureus, 2021, 13(12): e20781.
14.	Spaans Louisa N, Bousema Jelle E, van den Broek Frank JC. Variation in postoperative pain management after lung surgery in the Netherlands: A survey of Dutch thoracic surgeons. Br J Anaesth, 2022, 128(3): e222-e225.
15.	Zengin M, Sazak H, Baldemir R, et al. Parameters affecting nausea and vomiting after thoracoscopic wedge resection in patients with pneumothorax. Cureus, 2021, 13(11): e19926.
16.	An G, Zhang Y, Chen N, et al. Opioid-free anesthesia compared to opioid anesthesia for lung cancer patients undergoing video-assisted thoracoscopic surgery: A randomized controlled study. PLoS One, 2021, 16(9): e0257279.
17.	Zhang Y, Yan W, Chen Y, et al. Lower background infusion of oxycodone for patient-controlled intravenous analgesia, combined with ropivacaine intercostal nerve block, in patients undergoing thoracoscopic lobectomy for lung cancer: A randomized, double-blind, controlled clinical trial. Drug Des Devel Ther, 2021, 15: 3535-3542.
18.	Ranganath YS, Ramanujam V, Onodera Y, et al. Impact of paravertebral blocks on analgesic and non-analgesic outcomes after video-assisted thoracoscopic surgery: A propensity matched cohort study. PLoS One, 2021, 16(5): e0252059.
19.	邓淇尹, 钟君, 刘永峰, 等. 无线镇痛系统的研制. 北京生物医学工程, 2019, 38(1): 82-88.
20.	François T, Blanloeil Y, Pillet F, et al. Effect of interpleural administration of bupivacaine or lidocaine on pain and morphine requirement after esophagectomy with thoracotomy: A randomized, double-blind and controlled study. Anesth Analg, 1995, 80(4): 718-723.

1. Wei W, Zheng X, Gu Y, et al. Effect of general anesthesia with thoracic paravertebral block on postoperative delirium in elderly patients undergoing thoracoscopic lobectomy: A randomized-controlled trial. BMC Anesthesiol, 2022, 22(1): 1.
2. Morlion B, Schäfer M, Betteridge N, et al. Non-invasive patient-controlled analgesia in the management of acute postoperative pain in the hospital setting. Curr Med Res Opin, 2018, 34(7): 1179-1186.
3. Xing X, Bai Y, Sun K, et al. Single nucleotide polymorphisms associated with postoperative inadequate analgesia after single-port VATS in Chinese population. BMC Anesthesiol, 2020, 20(1): 38.
4. Wang R, Wang S, Duan N, et al. From Patient-controlled analgesia to artificial intelligence-assisted patient-controlled analgesia: Practices and perspectives. Front Med (Lausanne), 2020, 7: 145.
5. 陈烨, 王迪, 刘敏, 等. 临床智能化疼痛管理的研究进展. 中华麻醉学杂志, 2020, 40(11): 1405-1408.
6. Bhattarai R, Hamal PK. Comparison of fentanyl-propofol and ketamine-propofol combination in induction and maintenance with intravenous anesthesia for short surgical procedures at moderate elevations. J Nepal Health Res Counc, 2021, 18(4): 769-775.
7. Lee A, Seyednejad N, Lawati YA, et al. Evolution of process and outcome measures during an enhanced recovery after thoracic surgery program. J Chest Surg, 2022, 55(2): 118-125.
8. Komatsu R, Nash M, Peperzak KA, et al. Comparison between preoperative methadone and buprenorphine use on postoperative opioid requirement: A retrospective cohort study. Clin J Pain, 2022, 38(5): 311-319.
9. Kutlu Yalcin E, Kim D, Mao G, et al. Effect of intraoperative subhypnotic infusion of propofol on postoperative nausea and vomiting: A retrospective analysis. J Clin Anesth, 2022, 78: 110672.
10. Chen J, Luo Q, Huang S, et al. Effect of opioid-free anesthesia on postoperative analgesia after laparoscopic gynecologic surgery. Minerva Anestesiol, 2022, 88(6): 439-447.
11. 何君君. 成人术后静脉镇痛的历史及进展. 医学临床研究, 2019, 36(12): 2381-2383.
12. 杨秋红, 张益维, 黄长顺. 无线远程监控镇痛泵与普通镇痛泵系统临床应用效果比较. 浙江医学, 2018, 40(16): 1847-1849, 1854.
13. Ulger G, Baldemir R. Comparison of patient-controlled analgesia with tramadol or morphine after video-assisted thoracoscopic surgery in geriatric patients. Cureus, 2021, 13(12): e20781.
14. Spaans Louisa N, Bousema Jelle E, van den Broek Frank JC. Variation in postoperative pain management after lung surgery in the Netherlands: A survey of Dutch thoracic surgeons. Br J Anaesth, 2022, 128(3): e222-e225.
15. Zengin M, Sazak H, Baldemir R, et al. Parameters affecting nausea and vomiting after thoracoscopic wedge resection in patients with pneumothorax. Cureus, 2021, 13(11): e19926.
16. An G, Zhang Y, Chen N, et al. Opioid-free anesthesia compared to opioid anesthesia for lung cancer patients undergoing video-assisted thoracoscopic surgery: A randomized controlled study. PLoS One, 2021, 16(9): e0257279.
17. Zhang Y, Yan W, Chen Y, et al. Lower background infusion of oxycodone for patient-controlled intravenous analgesia, combined with ropivacaine intercostal nerve block, in patients undergoing thoracoscopic lobectomy for lung cancer: A randomized, double-blind, controlled clinical trial. Drug Des Devel Ther, 2021, 15: 3535-3542.
18. Ranganath YS, Ramanujam V, Onodera Y, et al. Impact of paravertebral blocks on analgesic and non-analgesic outcomes after video-assisted thoracoscopic surgery: A propensity matched cohort study. PLoS One, 2021, 16(5): e0252059.
19. 邓淇尹, 钟君, 刘永峰, 等. 无线镇痛系统的研制. 北京生物医学工程, 2019, 38(1): 82-88.
20. François T, Blanloeil Y, Pillet F, et al. Effect of interpleural administration of bupivacaine or lidocaine on pain and morphine requirement after esophagectomy with thoracotomy: A randomized, double-blind and controlled study. Anesth Analg, 1995, 80(4): 718-723.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of wireless analgesic system in pain management after thoracoscopic lung resection: A retrospective cohort study with large sample

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