Discussion
chronic pain, pain
CHRONIC PAIN
This prospective, interventional, single-blind, randomized study reveals that the combination of intrathecal morphine and bupivacaine offers effective analgesia for patients undergoing VATS. Compared to conventional general anesthesia, this anesthesia approach delivered superior pain control during the first 48 h post-surgery, leading to a lower cumulative consumption of IVPCA sufentanil and a reduced necessity for rescue analgesics over the same period. Compared to conventional general anesthesia, this anesthesia approach delivered superior pain control during the first 48 h post-surgery, leading to a lower cumulative consumption of IVPCA sufentanil and a reduced necessity for rescue analgesics over the same period. Aligning with prior research, our findings suggest that intrathecal morphine and bupivacaine are viable alternatives to epidural blocks, particularly for thoracoscopic procedures that necessitate higher levels of analgesia. The expedited administration process of morphine and bupivacaine intrathecal injections, as opposed to the longer duration required for intrathecal morphine alone, potentially renders them more suitable for clinical use. Our results corroborate that a singular intrathecal injection of low-dose morphine in conjunction with bupivacaine can effectively bridge the gap in analgesia due to the gradual onset of intrathecal morphine’s effects [Intrathecal morphine, when used alongside sufentanil and combined with an epidural infusion of bupivacaine and fentanyl in the thoracic segment, has been demonstrated to provide analgesic effects equivalent to those achieved in post-thoracoscopic analgesia [In our study, we utilized the 10 Trendelenburg position, ensuring rapid intrathecal drug administration within 15 s to aid the dispersion of the agents to the thoracic region. The sensory block level was assessed with an alcohol swab, achieving a blockade up to the T2 dermatome prior to anesthesia induction. This effectively corresponded with the T2 to T10 dermatomal pain regions implicated in VATS incisions, providing effective analgesia during the operation and minimizing the necessity for the intraoperative opioid remifentanil.The study by Dhawan et al. [As the ERAS paradigm advances, the adoption of accelerated-track anesthesia is increasingly recommended. This strategy emphasizes prompt postoperative awakening, expeditious extubation, and early mobilization. Referencing Table The Quality of QoR-40 is recognized as a significant measure of patient health status during the initial postoperative phase [This study is not without its limitations. Foremost, the relatively modest sample size and the exclusion of high-risk patients may introduce a degree of bias into the findings. Additionally, the investigation was confined to a single dose of ITM at 5 μg/kg, precluding a comparative analysis across a spectrum of dosages.The experiments of this group are continuing and will further explore the appropriate dose to apply to the patient. Finally, the scope of this research was limited to the assessment of early postoperative recovery quality, neglecting the potential effects on long-term recuperation and the development of chronic pain in patients. For the long-term effects, the results of studies using multi-centre and large samples may be more convincing, and our group is also trying to collaborate with a number of hospitals to conduct multi-centre studies, and expects to demonstrate satisfactory results in the future.