Background: Adequate pain control after cardiac surgery is essential. Paravertebral block is a simple technique and avoids the potential complications of epidural catheters. The objective of this study is to compare the effect of ultrasound-guided bilateral thoracic paravertebral block with thoracic epidural block on pain control after cardiac surgery.
Materials And Methods: Between March 2016 and 2017, 145 patients who had cardiac surgery through median sternotomy were randomized by stratified blocked randomization into two groups. Group I ( = 70 patients) had bilateral ultrasound-guided thoracic paravertebral block and Group II ( = 75 patients) had thoracic epidural analgesia. The primary end point was the postoperative visual analogue scale (VAS). The duration of mechanical ventilation, intensive care unit (ICU), and hospital stay were the secondary end points. The study design is a randomized parallel superiority clinical trial.
Results: Both groups had similar preoperative and operative characteristics. No significant difference in VAS measured immediately after endotracheal extubation then after 12, 24, and 48 hours between groups ( = 0.45). Pain score significantly declined with the repeated measures (< 0.001) and the decline was not related to the treatment group. Postoperative pain was significantly related to diabetes mellitus ( = 0.039). Six patients in group I (8.5%) required an additional dose of morphine versus three patients (4%) in group II ( = 0.30). Patients in group I had significantly shorter ICU stay ( = 0.005) and lower incidence of urinary retention ( = 0.04) and vomiting ( = 0.018). No difference was found in operative complications between groups.
Conclusion: This randomized parallel controlled trial demonstrates that ultrasound-guided paravertebral block is safe and effective method for relieving post-cardiac surgery sternotomy pain compared with thoracic epidural analgesia but not superior to it.
Department of Anesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. Electronic address:
Background: This study evaluated the spread of a local anesthetic, using MRI and sensory blockade, after an intertransverse process block (ITPB) at the medial aspect of the retro-superior costotransverse ligament (retro-SCTL) space - the medial retro-SCTL space block.
Methods: Ten healthy volunteers received a single-injection ultrasound-guided medial retro-SCTL space block at the T4-T5 level using a mixture of 10 ml 0.5 % bupivacaine with 0.
Background: Effective postoperative analgesia enhances the patient's comfort and facilitates early mobilization and recovery.
Objective: This study compared the analgesic efficacy of the erector spinae plane block (ESPB), thoracic paravertebral block (TPVB), and quadratus lumborum block (QLB) for pelvi-ureteric surgeries. The primary outcome measure in the study was the total morphine consumption during the first 48 hours following the operation.
This study evaluates the effectiveness of adding dexmedetomidine (DEX) to Thoracic Paravertebral Block (TPVB) for managing postoperative pain in patients undergoing thoracic surgery.
Six patients were monitored after receiving TPVB with ropivacaine, DEX, and methylene blue, focusing on pain levels and opioid use in the first 48 hours post-surgery.
Results indicated that patients experienced low pain scores and reduced opioid consumption without significant side effects, suggesting DEX enhances the effectiveness of TPVB while methylene blue aids in ensuring proper anesthetic distribution.
Objectives: This study compared the postoperative analgesic efficacy of serratus anterior plane block (SAPB) and thoracic paravertebral block (PVB) in children undergoing video-assisted thoracoscopic surgery.
Setting: Operating room and intensive care unit of a tertiary care hospital.
Design: A single-center, randomized, comparative, open-labeled study.
