Background: Thoracotomy causes severe pain in the postoperative period. Perioperative thoracic paravertebral block reduces pain score and may improve outcome after pediatric cardiac surgery. This prospective study was designed for the efficacy and duration of a single level, single injection ultrasound-guided thoracic paravertebral block (TPVB) for fifteen infants undergoing aortic coarctation repair.
Methods: After approval of the ethical committee and the relatives of the patients, 15 infants who had undergone thoracotomy were enrolled in the study. The patients received 0.5 ml·kg(-1) a bolus 0.25% bupivacaine with epinephrine 1 : 200 000 at T5-6 level after standard general anesthesia induction. Anesthesia depth with Index of Consciousness (IOC) and tissue oxygen saturation with cerebral (rSO2-C) and somatic thoracodorsal (rSO2-S) were monitored. Intraoperative hemodynamic and postoperative hemodynamic and pain scores were evaluated for 24 h after surgery. Face, Legs, Activity, Cry, Consolability (FLACC) score was utilized to measure postoperative pain in the intensive care unit. Rescue 0.05 mg·kg(-1) IV morphine was applied to patients in whom FLACC was >3.
Results: The median age of the patients was 4.5 (1-11) months, and the median intraoperative endtidal isoflurane concentration was 0.6% (0.3-0.8). The amount of remifentanil used intraoperatively was 4.5 (2.5-14) μg·kg(-) (1) ·h(-1). Intraoperative heart rate and blood pressure values significantly decreased compared with values detected at 5th, 10th, and 15th min after TPVB application, after incision prior and after cross-clamp (P < 0.01). The median time of first dose of morphine application after block was 320 (185-430) min. The median morphine consumption in 24 h was 0.16 (0.09-0.4) mg·kg(-1). The median length of postoperative intensive care unit and in-hospital stay times was 23 (1-67) h and 4 (1-10) days, respectively.
Conclusion: We believe that TPVB, as part of a balanced anesthetic and analgesic regime, provides effective pain relief in patients undergoing aortic coarctation repair.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/pan.12252 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Development and validation of a prediction model for chronic post-surgical pain risk: a single-center prospective study of video-assisted thoracoscopic lung cancer surgery.
J Cardiothorac Surg
January 2025
Department of Anesthesiology, The First People's Hospital of Chenzhou, Chenzhou, Hunan Province, 423000, China.
Background: Chronic post-surgical pain (CPSP) is a common complication following video-assisted thoracoscopic surgery (VATS) that significantly impacts the quality of life of patients. Although multiple risk factors have been identified, no systematically validated prediction model exists to guide clinical decision-making.
Objectives: This study aimed to develop and validate a risk prediction model for CPSP in patients undergoing VATS for lung cancer.
Advances in Anesthesia Techniques for Postoperative Pain Management in Minimally Invasive Cardiac Surgery: An Expert Opinion.
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address:
Minimally invasive cardiac surgery (MICS) often leads to severe postoperative pain. At present, multimodal analgesia schemes for MICS have attracted much attention, and the application of various chest wall analgesia techniques is becoming increasingly widespread. However, research on anesthesia techniques for postoperative pain management in MICS remains relatively limited at present.
View Article and Find Full Text PDFRationale and design for the thoracic Paravertebral Adjunctive Dexamethasone Palmitate Reducing chronic pain After cardiac surgery (PANDORA) trial: a parallel-group, double-blinded, randomised controlled, single-centre study.
BMJ Open
January 2025
Department of Anesthesiology and Perioperative Medicine, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
Introduction: Minimally invasive cardiac surgery (MICS) is important for enhanced recovery in cardiac surgery. However, the incidence of chronic postsurgical pain (CPSP) is high and is associated with worsened quality of recovery and life, as well as raised short-term or long-term mortality. The mechanism is not clear, and there is still a lack of safe and effective preventive measures.
View Article and Find Full Text PDFUltrasound-guided thoracic nerve blocks for emergency department patients with rib fractures: A review.
J Emerg Med
January 2025
Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina; Durham Veterans Affairs Healthcare System, 508 Fulton St, Durham, North Carolina. Electronic address:
Background: Rib fractures are frequently diagnosed and treated in the emergency department (ED). Thoracic trauma has serious morbidity and mortality, particularly in older adults, with complications including pulmonary contusions, hemorrhage, pneumonia, or death. Bedside ED-performed ultrasound-guided anesthesia is gaining in popularity, and early and adequate pain control has shown improved patient outcomes with rare complications.
View Article and Find Full Text PDFComparison of midazolam and dexmedetomidine combined with thoracic paravertebral block in hemodynamics, inflammation and stress response, and cognitive function in elderly lung cancer patients.
Int Immunopharmacol
January 2025
Department of Supervision Office, Changsha Health Vocational College, Changsha City, 410600, Hunan Province, China. Electronic address:
Objective: This study aimed to compare the clinical outcomes of midazolam and dexmedetomidine combined with ropivacaine-induced thoracic paravertebral nerve block (TPVB) in radical lung cancer surgery.
Methods: To retrospectively analyze the clinical data of elderly patients who underwent thoracoscopic radical lung cancer surgery from March 2020 to February 2023 in our hospital. All patients underwent a single two-site method of TPVB at the levels of T4 and T7 under ultrasound guidance.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!