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已发表论文
经心尖不停跳室间隔心肌切除术后肥厚型梗阻性心肌病患者疼痛：一项回顾性研究
Authors Qiu J, Li Y, Li R, Fang J, Liu W, Mei W , Wei X, Yao W
Received 20 August 2025
Accepted for publication 6 January 2026
Published 12 January 2026 Volume 2026:19 562160
DOI https://doi.org/10.2147/JPR.S562160
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Rushna Ali
Jin Qiu,1– 3 Yan Li,1– 3 Rui Li,4– 6 Jing Fang,4– 6 Wenhua Liu,7 Wei Mei,1– 3 Xiang Wei,4– 6 Wenlong Yao1– 3
1Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Hubei, People’s Republic of China; 3Clinical Research Center for Geriatric Anesthesia, Wuhan, People’s Republic of China; 4Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 5Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, People’s Republic of China; 6NHC Key Laboratory of Organ Transplantation, Ministry of Health, Wuhan, People’s Republic of China; 7Clinical Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
Correspondence: Wenlong Yao, Email wlyao82@126.com
Objective: This study aimed to evaluate the postoperative pain in patients with hypertrophic cardiomyopathy who underwent transapical beating-heart septal myectomy (TA-BSM) and to explore whether a thoracic paravertebral nerve block (TPVB) can effectively alleviate the postoperative pain resulting from this surgical procedure.
Methods: Patients aged 18– 75 years, classified as American Society of Anesthesiologists II–III, who underwent TA-BSM between April and September 2023, were included. A total of 197 patients were initially enrolled and evaluated in this study. Following the application of the inclusion and exclusion criteria, 136 participants were allocated to two cohorts: a control group (CON group) and a TPVB group, based on whether a TPVB was administered before the surgical intervention. Demographic data, perioperative characteristics, visual analog scale scores, analgesic strategy, and Quality of recovery-15 scores were evaluated.
Results: After inverse probability of treatment weighting (IPTW) adjustment, the standardized mean difference in baseline characteristics between the two groups was < 0.1. The incidence of moderate-to-severe pain on postoperative day 7 was 51.7% in the TPVB group compared to 71.1% in the CON group. The adjusted relative risk for moderate-to-severe pain was 0.748 [95% CI, 0.565 to 0.990] via IPTW analysis. The oral morphine equivalent administered via PCA during the initial 48 hours post-surgery was significantly lower in the TPVB group than in the CON group (225 vs 195; median difference, 34.5 [95% CI, 21 to 48]; P < 0.001).
Conclusion: Preoperative administration of a single TPVB before TA-BSM was associated with a reduced postoperative pain intensity, ranging from moderate to severe, and a subsequent decrease in opioid usage. TPVB may be a beneficial analgesic strategy for patients undergoing TA-BSM.
Keywords: thoracic paravetebral nerve block, transapical beating-heart septal myectomy, postoperative pain, regional anesthesia, opioid-sparing strategy
1Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Hubei, People’s Republic of China; 3Clinical Research Center for Geriatric Anesthesia, Wuhan, People’s Republic of China; 4Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 5Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, People’s Republic of China; 6NHC Key Laboratory of Organ Transplantation, Ministry of Health, Wuhan, People’s Republic of China; 7Clinical Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
Correspondence: Wenlong Yao, Email wlyao82@126.com
Objective: This study aimed to evaluate the postoperative pain in patients with hypertrophic cardiomyopathy who underwent transapical beating-heart septal myectomy (TA-BSM) and to explore whether a thoracic paravertebral nerve block (TPVB) can effectively alleviate the postoperative pain resulting from this surgical procedure.
Methods: Patients aged 18– 75 years, classified as American Society of Anesthesiologists II–III, who underwent TA-BSM between April and September 2023, were included. A total of 197 patients were initially enrolled and evaluated in this study. Following the application of the inclusion and exclusion criteria, 136 participants were allocated to two cohorts: a control group (CON group) and a TPVB group, based on whether a TPVB was administered before the surgical intervention. Demographic data, perioperative characteristics, visual analog scale scores, analgesic strategy, and Quality of recovery-15 scores were evaluated.
Results: After inverse probability of treatment weighting (IPTW) adjustment, the standardized mean difference in baseline characteristics between the two groups was < 0.1. The incidence of moderate-to-severe pain on postoperative day 7 was 51.7% in the TPVB group compared to 71.1% in the CON group. The adjusted relative risk for moderate-to-severe pain was 0.748 [95% CI, 0.565 to 0.990] via IPTW analysis. The oral morphine equivalent administered via PCA during the initial 48 hours post-surgery was significantly lower in the TPVB group than in the CON group (225 vs 195; median difference, 34.5 [95% CI, 21 to 48]; P < 0.001).
Conclusion: Preoperative administration of a single TPVB before TA-BSM was associated with a reduced postoperative pain intensity, ranging from moderate to severe, and a subsequent decrease in opioid usage. TPVB may be a beneficial analgesic strategy for patients undergoing TA-BSM.
Keywords: thoracic paravetebral nerve block, transapical beating-heart septal myectomy, postoperative pain, regional anesthesia, opioid-sparing strategy