European Journal of Cardio-Thoracic Surgery 0 (2018) 1 LETTER TO THE EDITOR I would welcome some comments by the authors as this would help to Intraoperative analgesic regimens may further substantiate the ﬁndings of this important clinical study. affect postoperative pain: single-port versus multi-port video-assisted thoracic surgery REFERENCES Mark C. Kendall*  Li Q, Sihoe A, Wang H, Gonzalez-Rivas D, Zhu Y, Xie D et al.Short- Department of Anesthesiology, Rhode Island Hospital, The Warren Alpert term outcomes of single- versus multi-port video-assisted thoracic Medical School of Brown University, Providence, RI, USA surgery in mediastinal diseases. Eur J Cardiothorac Surg 2018;53: 216–20. Received 12 February 2018; accepted 18 March 2018  Niraj G, Kelkar A, Kaushik V, Tang Y, Fleet D, Tait F et al. Audit of postop- erative pain management after open thoracotomy and the incidence of Keywords: Thoracic surgery � Acute pain � Analgesic regimen chronic postthoracotomy pain in more than 500 patients at a tertiary center. J Clin Anesth 2017;36:174–7. I read with great interest the article by Li et al.  in a recent issue of the jour-  Fiorelli A, Santini M. Total intravenous anaesthesia with local anaesthe- nal. The authors performed a retrospective study on 285 patients to compare sia for controlling pain after spontaneous ventilation video-assisted single-port video-assisted thoracic surgery with the multi-port variants in thoracic surgery: is it a viable strategy? Eur J Cardiothorac Surg 2017;52: terms of short-term perioperative outcomes and concluded that single-port video-assisted thoracic surgery has potential advantages of less postoperative  Kıtlık A, Erdogan MA, Ozgul U, Aydogan MS, Ucar M, Toprak HI et al. pain when compared with multi-port techniques. The authors should be con- Ultrasound-guided transversus abdominis plane block for postoperative gratulated for performing a study on an important topic (e.g. acute pain) in analgesia in living liver donors: a prospective, randomized, double- patients undergoing thoracic surgery [2,3]. The current emphases on the need blinded clinical trial. J Clin Anesth 2017;37:103–7. to improve postsurgical pain and reduce opioid intake makes the topic very  Chong MA, Wang Y, Dhir S, Lin C. Programmed intermittent peripheral relevant in perioperative medicine [4,5]. nerve local anesthetic bolus compared with continuous infusions for Although the study by Li et al. was well conducted, there are some ques- postoperative analgesia: a systematic review and meta-analysis. J Clin tions regarding the study that need to be clariﬁed. First, it is not clear whether Anesth 2017;42:69–76. the intraoperative analgesic regimens were standardized for all patients as this can substantially affect the study outcomes. Second, it is unclear whether any patient received a thoracic epidural as part of their analgesic management, *Corresponding author. Department of Anesthesiology, Warren Alpert Medical which is regarded as the standard of care for postoperative pain control in School Brown University, 593 Eddy Street, Providence, RI 02903, USA. these types of surgical cases. Finally, although the patients were recruited con- Tel: +1-401-4444933; fax: +1-401-4445090; e-mail: email@example.com secutively, it is not clear how each patient was allocated to the study groups (M.C. Kendall). (e.g. surgeon’s preference and disease extension) as this can result in a signiﬁ- cant selection bias for the study outcomes. doi:10.1093/ejcts/ezy143 The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. Downloaded from https://academic.oup.com/ejcts/advance-article-abstract/doi/10.1093/ejcts/ezy143/4962536 by Ed 'DeepDyve' Gillespie user on 12 July 2018 LETTER TO THE EDITOR
European Journal of Cardio-Thoracic Surgery – Oxford University Press
Published: Apr 6, 2018
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