Key result
Intravenous fentanyl combined with peripheral nerve block significantly improved early postoperative analgesia, with 100% of patients achieving an NRS < 3/10 at 3 hours compared to 60% with nerve block alone (p=0.0343).
Why the study?
Relative contraindications to epidural blocks are increasing in thoracic surgery patients, necessitating multimodal analgesia alternatives such as peripheral nerve blocks and systemic opioids.
Does peripheral nerve block combined with intravenous fentanyl improve postoperative analgesia compared to peripheral nerve block alone in patients with relative contraindications to epidural block undergoing thoracic surgery?
Cohort (n=28)
No
Does peripheral nerve block combined with intravenous fentanyl improve postoperative analgesia compared to peripheral nerve block alone in patients with relative contraindications to epidural block undergoing thoracic surgery?
Absolute Event Rate: 100% vs 60%
p-value: p=0.0343
Combining intravenous fentanyl with peripheral nerve block provides superior early postoperative analgesia without increasing adverse events in thoracic surgery patients contraindicated for epidural anesthesia.
May support adjunctive IV fentanyl for early analgesia after nerve block; hypothesis-generating and needs randomized confirmation.
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Ozawa et al. (2022) conducted a cohort in Thoracic surgery with relative contraindications for epidural block (n=28). Intravenous fentanyl combined with peripheral nerve block vs. Peripheral nerve block alone was evaluated on NRS < 3/10 at 3 hours after entering ICU (p=0.0343). Intravenous fentanyl combined with peripheral nerve block significantly improved early postoperative analgesia, with 100% of patients achieving an NRS < 3/10 at 3 hours compared to 60% with nerve block alone (p=0.0343).
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