KẾT QUẢ CHĂM SÓC GIẢM ĐAU SAU PHẪU THUẬT NỘI SOI ĐẶT THANH NÂNG NGỰC TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

In patients underwent endoscopic Nuss procedure for pectus excavatum, at Vietnam National Children's Hospital, postoperative pain reduces the patient's mobility, adversely affects lung function, increases the rate of postoperative complications, and may lead to chronic post-surgical pain syndrome. Thoracic epidural analgesia is often considered the gold standard for post-thoracic surgery pain treatment. We conducted a study to evaluate the effectiveness of thoracic epidural analgesia in patients after endoscopic Nuss procedure for pectus excavatum with 0.125% Bupivacaine combined with 2 mcg/ml Fentanyl at an infusion rate of 4 - 6ml/hour. Method: Prospective descriptive studyof 112 patients from June 2023 to December 2023. The results showed that thoracic epidural analgesia via an epidural catheter in endoscopic Nuss procedure provided effective pain relief both at rest and during movement, with minimum side effects. On the first postoperative day, only 9.83% of patients had a VAS score of 3 - 4 and required additional pain medication. Over 90% of patients had a VAS score of 0 - 2 both at rest and during movement in the first three days after surgery. The percentage of patients with no or mild pain (VAS 0 - 2) during movement increased from 72.32% on the first day to 91.96% on the second day after surgery. The incidence of adverse effects was low, with vomiting (1.80%), nausea (9.82%) on the first post operative day; limb numbness (2.70%), itching (1.80%) at very low rates. 86.60% patients were satisfied with the pain management, while 36.60% were extremely satisfied. Conclusion: The satisfaction level of patients with the effectiveness of thoracic epidural analgesia in endoscopic Nuss procedure was high, with a low rate of adverse effects.