Evidence map›Paper›PMID 37941433›Full record

ArticleInterdisciplinary cardiovascular and thoracic surgery2023

Pain management after pneumothorax surgery: intercostal nerve block or thoracic epidural analgesia.

Louisa N Spaans, Quirine C A van Steenwijk, Adelina Seiranjan, Nicky Janssen, Erik R de Loos, Denis Susa, Jan P Eerenberg, R A Arthur Bouwman, Marcel G Dijkgraaf, Frank J C van den Broek

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Interdisciplinary cardiovascular and thoracic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Progressive Versus Conservative Chest Tube Management Following Surgery for Primary Spontaneous Pneumothorax.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026
    Article
  3. Article
  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Louisa N SpaansDepartment of Surgery, Maxima Medical Center, Eindhoven, Netherlands.ORCID 0000-0001-8667-3780
Quirine C A van SteenwijkDepartment of Surgery, Maxima Medical Center, Eindhoven, Netherlands.
Adelina SeiranjanDepartment of Surgery, Maxima Medical Center, Eindhoven, Netherlands.
Nicky JanssenDepartment of Surgery, Zuyderland Medical Centre, Heerlen, Netherlands.
Erik R de LoosDepartment of Surgery, Zuyderland Medical Centre, Heerlen, Netherlands.ORCID 0000-0001-6313-2658
Denis SusaDepartment of Surgery, Bravis Hospital, Bergen op Zoom, Netherlands.
Jan P EerenbergDepartment of Surgery, Tergooi Medical Centre, Hilversum, Netherlands.
R A Arthur BouwmanDepartment of Anesthesiology and Pain Medicine, Catharina Hospital, Eindhoven, Netherlands.
Marcel G DijkgraafDepartment of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.
Frank J C van den BroekDepartment of Surgery, Maxima Medical Center, Eindhoven, Netherlands.
Radboud University Nijmegen · NLZuyderland Medisch Centrum · NLBravis Ziekenhuis · NLGGD Amsterdam · NLTergooi · NL

Funding

Maxima Medical Center in Eindhoven 10140021910007
6 · The paper itself

Abstract

objectivesIn patients undergoing video-assisted thoracoscopic surgery for pneumothorax, the benefits and risks of single-shot intercostal nerve block as loco-regional analgesia are not well known. We retrospectively compared the effectiveness of intercostal nerve blocks as a viable alternative to thoracic epidural analgesia (TEA) regarding pain control and enhanced recovery.

methodsA retrospective multicentre analysis with single-centre propensity score matching was performed in patients undergoing video-assisted thoracoscopic surgery for pneumothorax receiving either TEA or intercostal nerve block. The primary outcome was a proportion of pain scores ≥4 (scale 0-10) until postoperative day (POD) 3. Secondary outcomes included variation in pain over time, additional opioid use, length of stay, mobility, complications and recurrence rate.

resultsIn 218 patients, TEA was compared to intercostal nerve block and showed no difference in the proportion of pain scores ≥4 {14.3% [interquartile range (IQR) 0.0-33.3] vs 11.1% (IQR 0.0-27.3) respectively, P = 0.24}, more frequently needed additional opioids on the day of surgery (18% vs 48%) and first POD (20% vs 42%), had a shorter length of stay (4.0 days [IQR 3.0-7.0] vs 3.0 days [IQR 2.8-4.0]) and were significantly more mobile until POD 3, while having similar recurrences. Intercostal nerve block had higher pain scores early in the course whereas TEA had higher late (rebound) pain scores.

conclusionsIn a multimodal analgesic setting with additional opioids, intercostal nerve block shows comparable moments of unacceptable pain from POD 0-3 compared to TEA and is linked to improved mobility. Results require randomized confirmation.

Indexed as

Enhanced recovery after thoracic surgeryEpiduralIntercostal blockPneumothoraxVideo-assisted thoracoscopic surgery

Identifiers

PMID37941433
PMCPMC10645434
OpenAlexW4388532245

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.