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Analgesia and pulmonary function after lung surgery: is a single intercostal nerve block plus patient-controlled intravenous morphine as effective as.

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Presentation on theme: "Analgesia and pulmonary function after lung surgery: is a single intercostal nerve block plus patient-controlled intravenous morphine as effective as."— Presentation transcript:

1 Analgesia and pulmonary function after lung surgery: is a single intercostal nerve block plus patient-controlled intravenous morphine as effective as patient-controlled epidural anaesthesia? A randomized non-inferiority clinical trial  R. Meierhenrich, D. Hock, S. Kühn, E. Baltes, B. Muehling, R. Muche, M. Georgieff, G. Gorsewski  British Journal of Anaesthesia  Volume 106, Issue 4, Pages (April 2011) DOI: /bja/aeq418 Copyright © 2011 The Author(s) Terms and Conditions

2 Fig 1 Participant flow. EDA, epidural anaesthesia; POD, postoperative day. British Journal of Anaesthesia  , DOI: ( /bja/aeq418) Copyright © 2011 The Author(s) Terms and Conditions

3 Fig 2 Pain course at rest (a), on coughing (b), and ‘maximum pain experienced since last questioning’ (c). Data given as median and 95% confidential interval of the median. *P<0.05; **P<0.01: comparison between the epidural and intercostal groups (Mann–Whitney rank sum test). NRS, numeric rating scale; POD1, POD2, POD3, and POD 4, first, second, third, and fourth postoperative day. British Journal of Anaesthesia  , DOI: ( /bja/aeq418) Copyright © 2011 The Author(s) Terms and Conditions

4 Fig 3 Median treatment differences for NRS scores at rest on the first postoperative day. Error bars indicate two-sided 95% confidence intervals. Δ, margin of non-inferiority. Non-tinted area indicates zone of inferiority. NRS, numeric rating scale. British Journal of Anaesthesia  , DOI: ( /bja/aeq418) Copyright © 2011 The Author(s) Terms and Conditions

5 Fig 4 Time course of pulmonary function: IVC (a), FVC (b), PEFR (c), and FEV1 (d). The median, 5% percentile, 95% percentile, and inter-quartile range (box) are shown. P-value, comparison between the epidural and intercostal groups (Mann–Whitney rank-sum test). IVC, inspiratory vital capacity; FVC, forced vital capacity; PEFR, peak expiratory flow rate; FEV1, forced expiratory volume 1; POD1, POD2, POD3, and POD 4, first, second, third, and fourth postoperative day. British Journal of Anaesthesia  , DOI: ( /bja/aeq418) Copyright © 2011 The Author(s) Terms and Conditions

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