Table 1. Characteristics and outcomes of patients undergoing minimally invasive lung resections by postoperative pain strategy.
| Variables | LB (n=326) | TEA (n=65) | P value |
|---|---|---|---|
| Gender (female) | 209 (64.1) | 38 (58.5) | 0.40 |
| Charlson comorbidity index | 5±3 | 5±2 | 0.20 |
| ASA score | 0.25 | ||
| 2: mild systemic disease | 8 (2.5) | 3 (4.6) | |
| 3: severe systemic disease | 308 (94.5) | 62 (95.4) | |
| 4: incapacitating systemic disease | 10 (3.1) | 0 (0.0) | |
| Age at surgery (years) | 66 [26–88] | 72 [51–88] | 0.001 |
| FEV1 (% of predicted) | 88 [23–157] | 80 [65–96] | 0.004 |
| FEV1 ≥80% predicted | 227 (69.6) | 33 (50.8) | 0.004 |
| FEV1 50–79% predicted | 88 (27.0) | 23 (35.4) | 0.18 |
| FEV1 <50% predicted | 11 (3.4) | 9 (13.8) | 0.002 |
| Surgery type | <0.001 | ||
| Lobectomy | 63 (19.3) | 41 (63.1) | |
| Sublobar resection | 263 (80.7) | 24 (36.9) | |
| Indication | 0.086 | ||
| Malignancy | 272 (83.4) | 60 (92.3) | |
| Benign disease | 54 (16.6) | 5 (7.7) | |
| Patients with adverse events† | 57 (17.5) | 22 (33.8) | 0.004 |
| Grade II | 49 (15.0) | 20 (30.8) | 0.004 |
| Grade III | 16 (4.9) | 4 (6.2) | 0.76 |
| Grade IV | 5 (1.5) | 3 (4.6) | 0.13 |
| Perioperative mortality | 1 (0.3) | 0 (0.0) | >0.99 |
| Pain scores | |||
| PACU | 5 [0–10] | 6 [0–10] | 0.107 |
| 12 hours | 3 [0–10] | 4 [0–10] | 0.38 |
| 24 hours | 4 [0–10] | 5 [0–10] | 0.03 |
| 48 hours‡ | 2 [0–8] | 3 [0–10] | 0.001 |
| MME | |||
| 24 hours | 45 [0–440] | 38 [0–165] | 0.41 |
| 48 hours‡ | 20 [0–244] | 30 [0–143] | 0.03 |
| Non-narcotic analgesic adjuncts | |||
| Ketorolac | 178 (54.6) | 33 (50.8) | 0.59 |
| Gabapentin | 184 (56.4) | 34 (52.3) | 0.59 |
| Acetaminophen | 325 (99.7) | 64 (98.5) | 0.31 |
| Ibuprofen | 153 (46.9) | 26 (40.0) | 0.34 |
| Hospital LOS (days) | 2 [1–18] | 4 [1–22] | <0.001 |
Data are presented as n (%), mean ± SD, or median [range]. †, includes patients who experienced more than one adverse event; ‡, for patients with hospital LOS ≥2 days (n=323). Sixty-eight patients were excluded from the LB group and one patient from TEA group. LB, liposomal bupivacaine; TEA, thoracic epidural analgesia; ASA, American Society of Anesthesiologists; FEV1, forced expiratory volume in 1 second; PACU, post-anesthesia care unit; MME, morphine milligram equivalent; LOS, length of stay; SD, standard deviation.