Liposomal Bupivacaine Intercostal Block Is Important for Reduction of Pulmonary Complications

医学 布比卡因 麻醉 肋间神经 外科
作者
Erin M. Corsini,K. G. Mitchell,Nicolas Zhou,Mara B. Antonoff,Reza J. Mehran,Gabriel E. Mena,Ravi Rajaram,Jack A. Roth,Boris Sepesi,Stephen G. Swisher,Ara A. Vaporciyan,Garrett L. Walsh,David C. Rice,Wayne L. Hofstetter
出处
期刊:The Annals of Thoracic Surgery [Elsevier BV]
卷期号:112 (2): 423-429 被引量:12
标识
DOI:10.1016/j.athoracsur.2020.09.017
摘要

Background We have previously demonstrated that Enhanced Recovery After Surgery protocols are associated with a reduction in pulmonary complications. As a component of enhanced recovery pathways, intercostal nerve blocks with liposomal bupivacaine are increasingly utilized, but the extent to which this element may contribute to such outcomes has not been evaluated. Methods Patients undergoing lung resection for stage I to III non-small cell lung cancer at a single institution from 2006 to 2017 were examined for major postoperative pulmonary morbidity, defined as pneumonia, acute respiratory distress syndrome, respiratory arrest, reintubation, bronchoscopy, or need for discharge with oxygen. Pharmacy records were queried for administration of liposomal bupivacaine via posterior intercostal nerve block. Patients treated with and without liposomal bupivacaine were compared in a logistic regression to determine the impact on pulmonary morbidity. Results A total of 2865 patients were identified, including 860 (30%) who were treated with liposomal bupivacaine via posterior intercostal block. Pulmonary morbidity occurred in 455 (16%). Adoption of liposomal bupivacaine analgesia occurred over several years, beginning in 2012 to full adoption by 2017. Liposomal bupivacaine management was associated with a reduction in pulmonary complications, as compared with nonuse (odds ratio, 0.63; P = .006). Additional factors associated with the occurrence of pulmonary morbidity were age, body mass index, smoking, spirometry values, and operative blood loss. Conclusions As a component of an active enhanced recovery program, liposomal bupivacaine is associated with a reduction in major pulmonary complications, and utilization should be evaluated on a hospital-by-hospital basis. We have previously demonstrated that Enhanced Recovery After Surgery protocols are associated with a reduction in pulmonary complications. As a component of enhanced recovery pathways, intercostal nerve blocks with liposomal bupivacaine are increasingly utilized, but the extent to which this element may contribute to such outcomes has not been evaluated. Patients undergoing lung resection for stage I to III non-small cell lung cancer at a single institution from 2006 to 2017 were examined for major postoperative pulmonary morbidity, defined as pneumonia, acute respiratory distress syndrome, respiratory arrest, reintubation, bronchoscopy, or need for discharge with oxygen. Pharmacy records were queried for administration of liposomal bupivacaine via posterior intercostal nerve block. Patients treated with and without liposomal bupivacaine were compared in a logistic regression to determine the impact on pulmonary morbidity. A total of 2865 patients were identified, including 860 (30%) who were treated with liposomal bupivacaine via posterior intercostal block. Pulmonary morbidity occurred in 455 (16%). Adoption of liposomal bupivacaine analgesia occurred over several years, beginning in 2012 to full adoption by 2017. Liposomal bupivacaine management was associated with a reduction in pulmonary complications, as compared with nonuse (odds ratio, 0.63; P = .006). Additional factors associated with the occurrence of pulmonary morbidity were age, body mass index, smoking, spirometry values, and operative blood loss. As a component of an active enhanced recovery program, liposomal bupivacaine is associated with a reduction in major pulmonary complications, and utilization should be evaluated on a hospital-by-hospital basis.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
传奇3应助羊丢丢啊丢丢采纳,获得10
刚刚
18275412695发布了新的文献求助10
刚刚
易海之旅完成签到,获得积分10
刚刚
zzzzzzzp应助wnx001111采纳,获得10
1秒前
pluto应助王家腾采纳,获得10
1秒前
Jasper应助唐哈哈采纳,获得10
1秒前
1秒前
2秒前
2秒前
2秒前
LIN完成签到,获得积分10
3秒前
Lucas应助无昵称采纳,获得10
3秒前
4秒前
小许发布了新的文献求助10
4秒前
说书人发布了新的文献求助10
5秒前
完美世界应助TILLTHEEND采纳,获得10
5秒前
6秒前
6秒前
王昭发布了新的文献求助10
6秒前
6秒前
zzf完成签到,获得积分10
6秒前
英吉利25发布了新的文献求助10
7秒前
乐乐应助霸气以菱采纳,获得10
7秒前
思源应助sigla采纳,获得10
7秒前
8秒前
Jasper应助Ken采纳,获得10
8秒前
8秒前
煜钧发布了新的文献求助30
9秒前
9秒前
10秒前
Msure发布了新的文献求助10
10秒前
科研通AI5应助俏皮的冰姬采纳,获得30
10秒前
Tong123发布了新的文献求助10
11秒前
聪慧小霜应助飞云采纳,获得10
12秒前
zzzzzzzp应助wnx001111采纳,获得10
12秒前
13秒前
隐形曼青应助大剑日太刀采纳,获得10
13秒前
13秒前
jane发布了新的文献求助10
13秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Toward a Combinatorial Approach for the Prediction of IgG Half-Life and Clearance 500
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3970120
求助须知:如何正确求助?哪些是违规求助? 3514810
关于积分的说明 11176124
捐赠科研通 3250136
什么是DOI,文献DOI怎么找? 1795198
邀请新用户注册赠送积分活动 875647
科研通“疑难数据库(出版商)”最低求助积分说明 804964