ArticleJournal of pain research2025
Thoracic Epidural Block versus Conscious Sedation with Intercostal Nerve Block for Thermal Ablation of Lung Tumors: A Comparative Study.
Article in Journal of pain research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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8 authors.
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Abstract
Background: To evaluate the analgesic effects between thoracic epidural block (TEB) and conscious sedation with intercostal nerve block (CSINB) in patients undergoing thermal lung tumor ablation. Methods: Medical records of patients with primary or secondary lung tumors who underwent thermal lung tumor ablation between 2011 and 2022 were reviewed. Primary outcome measures were pain intensity evaluated using the visual analog scale (VAS) and additional morphine use within 48 hours after the procedure. Secondary outcome measures were adverse events during and after surgery. Results: Among 72 patients (median age 68, 61.1% male), 31 received CSINB and 41 received TEB. The TEB group had significantly fewer patients with VAS ≥ 5 (2.4% vs 25.8%, p = 0.004) and less additional morphine use (24.4% vs 77.4%, p < 0.001). Multivariable analysis showed that TEB reduced the risk of post-procedural pain (adjusted odds ratio [aOR], 0.04; 95% confidence interval [CI], 0.003-0.47) and additional morphine use (aOR: 0.08, 95% CI: 0.02-0.28). Hypotension occurred in 35 TEB patients and nausea in 5, both effectively managed with vasopressors and antiemetics. The incidence of fever, pneumothorax, pleural effusion, and pigtail drainage was similar between groups (p > 0.05). Conclusion: TEB provides superior analgesia compared to CSINB. Although patients with reduced pulmonary function were not analyzed as a separate subgroup, the favorable analgesic outcomes and absence of respiratory depression in the TEB group-including those with prior lobectomy and limited pulmonary reserve-indicate that this technique may be appropriate for patients with compromised respiratory function.
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