{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:33Z","timestamp":1772168913408,"version":"3.50.1"},"reference-count":22,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T00:00:00Z","timestamp":1541980800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20160522"],"award-info":[{"award-number":["20160522"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009769","name":"Mats Klebergs Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009769","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"crossref","award":["20160525"],"award-info":[{"award-number":["20160525"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Video-assisted thoracoscopic surgery (VATS) causes less postoperative pain than thoracotomy; however, adequate analgesia remains vital. As part of a multi-modal postoperative analgesia, a continuous surgeon-placed extrapleural block catheter is an option. The aim of this retrospective study was to evaluate the analgesic efficacy of a continuous extrapleural block as part of a multimodal analgesic regimen after VATS in general, and VATS lobectomy and wedge resection in particular.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    Case records for patients having undergone VATS surgery and been provided a multi-level continuous extrapleural block with an elastomeric pump infusing levobupivacaine 2.7 mg\/ml at a rate of 5 ml\/h during 2015 and 2016 were reviewed. Pain (Numeric Rating Scale) at rest and mobilisation as well as opioid requirement (daily, postoperative days 0-3, as well as accumulated) were analysed. \u00a0\u00a0\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    In all, 454 records were reviewed: 150 wedge resections, 264 lobectomies and 40 miscellaneous cases. At rest, pain was mild median NRS rated 3-3-1-1 for postoperative day (POD) 0 to 3, during movement, pain was rated moderate during POD 0 and 1 and mild the remaining days (median NRS 4-4-3-3 for POD 0-3). The proportion of patients exhibiting mild pain at rest increased from 55% on POD 0 to 81 % on POD 3. The percentage of patients experiencing severe pain at rest decreased from 15% to 6%. Median oxycodone consumption was 10 mg per day for POD 1-3. Pain after VATS wedge resection was significantly lower at POD 1 and 3 compared to pain after VATS lobectomy.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusion:<\/ns4:bold>\n                    We found a continuous surgeon-placed extrapleural catheter block to be a valuable and seemingly safe addition to our multimodal procedure specific analgesia after VATS. Whether the efficacy of the block can be improved by increasing local anaesthetic and\/or adding adjuncts warrants further investigation.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.16857.1","type":"journal-article","created":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T11:30:09Z","timestamp":1542022209000},"page":"1783","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Continuous surgical multi-level extrapleural block for video-assisted thoracoscopic surgery: a retrospective study assessing its efficacy as pain relief following lobectomy and wedge 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ribs.","volume":"57","author":"M Mohta","year":"2013","journal-title":"Indian J Anaesth."},{"key":"ref-18","doi-asserted-by":"publisher","first-page":"766-73","DOI":"10.1097\/EJA.0000000000000777","article-title":"Adding sufentanil to ropivacaine in continuous thoracic paravertebral block fails to improve analgesia after video-assisted thoracic surgery: A randomised controlled trial.","volume":"35","author":"C Bauer","year":"2018","journal-title":"Eur J Anaesthesiol."},{"key":"ref-19","doi-asserted-by":"crossref","first-page":"858-75","DOI":"10.1097\/00000542-200009000-00038","article-title":"Local anesthetics and the inflammatory response: a new therapeutic indication?","volume":"93","author":"M Hollmann","year":"2000","journal-title":"Anesthesiology."},{"key":"ref-20","doi-asserted-by":"publisher","first-page":"1149-63","DOI":"10.2165\/10898560-000000000-00000","article-title":"Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.18429.r43646, Colin F. Royse, Department of Surgery, University of Melbourne, Parkville, Victoria, Australia, 13 Feb 2019, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/7-1783\/v1#referee-response-43646","order":0,"name":"referee-response-43646","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.18429.r45938, Waldemar Gozdzik, Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Wroc\u0142aw, Poland, 15 Apr 2019, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/7-1783\/v1#referee-response-45938","order":1,"name":"referee-response-45938","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"U.S. was funded by the Swedish Heart-Lung Foundation [grant numbers 20160522, 20160525] and the Mats Kleberg Foundation. This study was supported by the Heart and Vascular Theme as well as the Function Perioperative Medicine and Intensive Care, Section for Cardiothoracic Anaesthesia and Intensive Care, both at Karolinska University Hospital, Stockholm. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Data associated with the article are available under the terms of the Creative Commons Zero \"No rights reserved\" data waiver (CC0 1.0 Public domain dedication).","order":0,"name":"copyright-info","label":"Copyright"}]}}