2012 annual meeting & cardiothoracic forum - Society for ...

ACTA-SCTS JOINT MEETING • Manchester Central Conference Centre
046a Effectiveness of Postoperative Analgesia in Lung Resection
Patients
Authors: Walker, E.J. 1 Matzelle, S. 2 Weightman, W. 2
1 Gartnavel General Hospital, United Kingdom, 2Sir Charles Gairdner Hospital,
Perth, Australia
Objectives:
1. To establish the effectiveness of postoperative analgesia in lung resection
patients in a thoracic referral centre.
2. To explore if the use of thoracoscopic surgery and regional analgesic techniques
have impacted on postoperative pain control.
Methods: This follow up audit was registered with the local quality improvement
service. 37 patients undergoing lung resection procedures were identified for the
period 15th March 2010 to 24th January 2011. A retrospective review of 30 case
notes was performed between 14th February and 31st March 2011 7 case notes
were inaccessible. Data are compared with audit data from 2005 practice.
Statistical analysis was performed using Students t-test.
Results: 30 patients with a mean age of 62 years underwent lung resection in the
45 week period; 7/30 (23%) had video assisted thoracoscopic surgery (VATS),
23/30 (27%) had open procedures. Regional analgesic techniques were performed
in 29/30 (97%) of cases; 2 3 (79%) of these were continuous catheter techniques,
increased from 61% in 2005. Pain scores (0-10 numerical scale) were comparable
for the two study periods but opioid use was significantly reduced during the first
24 hours in the 2010 study (see table).
2005 2010 p value
Pain score 0-24 hrs 2.8 2.8 .9
Pain score 24-48 hrs 1.9 1.8 0.9
Mean fentanyl equivalent dose 0-24 hrs 1411mcg 871mcg 0.006
Mean fentanyl equivalent dose 24-48 hrs 981mcg 617mcg 0.13
18/30 (60%) patients received patient controlled analgesia (PCA) postoperatively.
Those patients receiving PCAs had significantly higher first day median pain scores
(3.6 vs. 1.4, p=0.01) and opioid use (mean equivalent fentanyl dose 1275mcg vs.
265mcg (p