Analgesia in patients undergoing thoracotomy: Epidural versus paravertebral technique. A randomized, double-blind, prospective study

Raveglia, Federico; Rizzi, Alessandro; Leporati, A.; Mauro, P. Di; Cioffi, Ugo; Baisi, Alessandro

doi:10.1016/j.jtcvs.2013.09.024

Cited by 61 publications

(29 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Carmona et al reported that CPVB analgesia was an acceptable safe technique for early extubation with optimal pain control retrospectively compared with intravenous analgesia with opioids in 37 patients who underwent cardiac surgery [23]. Some authors showed that CPVB was a good pain reliever similar to EA in thoracic surgery [12–15], so we hypothesized that CPVB could potentially replace EA as the standard procedure in open-heart surgery. Although we did not record any pain scales to evaluate the degree of pain, our fentanyl consumption was small compared to past reports [19, 24–26], and our patients did not require multiple analgesics as we expected.…”

Section: Discussionmentioning

confidence: 99%

A case series of continuous paravertebral block in minimally invasive cardiac surgery

et al. 2017

View full text Add to dashboard Cite

BackgroundMinimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. For this, good coverage analgesia is essential. Epidural anesthesia, a standard technique for thoracic surgery, has high risk of complications, such as epidural abscess and spinal hematoma in open-heart surgery. Based on the hypothesis that continuous paravertebral block (CPVB), a less invasive regional anesthetic technique, is safe and effective in open-heart surgery, we applied CPVB to MICS with thoracotomy.FindingsTo assess whether CPVB could be used in open-heart surgery with fewer potential complications, we investigated our medical records of the 87 adult patients who underwent MICS at Akashi Medical Center, Hyogo, Japan, between March 2009 and May 2016. We collected data of CPVB-related complications, postextubation respiratory failure, duration of intubation, and other analgesic use from hospital clinical records. We observed no severe CPVB-related complications, such as hematoma, neuropathy, or abscess. PT-INR longer than 1.1 was associated with CPVB-related minor bleeding. Forty-three patients (47.4%) were extubated within 1 h after surgery, and there were no postextubation respiratory failures in any patients.ConclusionsWe observed no cases of severe CPVB-related complications or postextubation respiratory failure in any of our patients who underwent MICS. Preoperative prolongation of PT-INR was associated with CPVB-related minor bleeding.

show abstract

Section: Discussionmentioning

confidence: 99%

A case series of continuous paravertebral block in minimally invasive cardiac surgery

et al. 2017

View full text Add to dashboard Cite

show abstract

“…To mitigate these side effects, techniques using a catheter, such as continuousslow infusion of local anesthetics into the paravertebral or direct wound space, have recently been established (3)(4)(5). This paravertebral technique, according to Raveglia and colleagues (6), has superior results compared with the PCA methods in thoracotomy patients; however, it has not been fully evaluated with respect to VATS.…”

Section: Original Articlementioning

confidence: 99%

Intramuscular stimulation as a novel alternative method of pain management after thoracic surgery

Moon¹,

Park²,

Kang³

et al. 2019

J. Thorac. Dis

View full text Add to dashboard Cite

Background: The purpose of this study was to determine whether electrical twitch-obtaining intramuscular stimulation (ETOIMS) can be an alternative to intravenous patient-controlled analgesia (IV-PCA) for postoperative pain management in pneumothorax patients undergoing single-port video-assisted thoracoscopic surgery (VATS). Methods: This preliminary prospective randomized study was conducted between March 2017 and July 2017. A total of 26 patients undergoing single-port VATS were randomly assigned to two groups: the ETOIMS group (n=12), which received intramuscular stimulation prior to chest tube insertion toward the end of procedure, and the IV-PCA group (n=14), which received continuous infusion of fentanyl with a basal rate of 10 μg/mL/h. To measure postoperative pain, visual analogue scale (VAS; range, 0-10) was used as the primary endpoint. Results: Baseline characteristics were not different between the two groups. According to the linear mixed model, there was statistical difference in the serial VAS score between the two groups (P=0.007). The ETOIMS group showed a significantly lower VAS score compared with the IV-PCA group, especially at postoperatively hour 8, day 1, and day 2. Conclusions: We showed that ETOIMS may be a safe, effective, and simple alternative for pain management after single-port VATS.Moon et al. IMS after thoracic surgery (Medical Illustrator) for his help with the illustrations. FootnoteConflicts of Interest: The authors have no conflicts of interest to declare.

show abstract

“…El tratamiento adecuado del dolor agudo post-toracotomía facilita la recuperación funcional y disminuye las complicaciones pulmonares y el riesgo de cronificación (síndrome post-toracotomía) (1)(2)(3)(4). En nuestra experiencia, este dolor se controla adecuadamente con un protocolo de analgesia multimodal basado en el bloqueo epidural o paravertebral, asociado a antiinflamatorio no esteroideo (AINE), paracetamol y morfina de rescate, permitiendo una movilización del paciente en las primeras 24 horas.…”

Section: Introductionunclassified

Uso del parche de lidocaína al 5 % para el tratamiento del dolor postquirúrgico en cirugía de tórax

Sanchez¹,

Dalmau²,

Bocos³

et al. 2016

Rev. Soc. Esp. Dolor.

View full text Add to dashboard Cite

Instrucciones de citación para el artículo:Sánchez Daniel, Dalmau A., Bocos J., Ribes C., Sánchez A., Sabate A.. Uso del parche de lidocaína al 5 % para el tratamiento del dolor postquirúrgico en cirugía de tórax. Rev. Soc. Esp. Dolor. 2016. doi: 10.20986/resed.2016.3426/2016 Este es un archivo PDF de un manuscrito inédito que ha sido aceptado para su publicación en la Revista de la Sociedad Española del Dolor. Como un servicio a nuestros clientes estamos proporcionando esta primera versión del manuscrito en estado de prepublicación. El manuscrito será sometido a la corrección de estilo final, composición y revisión de la prueba resultante antes de que se publique en su forma final. Tenga en cuenta que durante el proceso de producción se pueden dar errores lo que podría afectar el contenido final. El copyright y todos los derechos legales que se aplican al artículo pertenecen a la Revista de la

show abstract

Analgesia in patients undergoing thoracotomy: Epidural versus paravertebral technique. A randomized, double-blind, prospective study

Abstract: According to our data, drugs administered through a paravertebral catheter are very effective. Moreover, it does not present contraindications to its positioning or collateral effects. More studies are necessary to confirm data we collected.

Cited by 61 publications

References 23 publications

A case series of continuous paravertebral block in minimally invasive cardiac surgery

A case series of continuous paravertebral block in minimally invasive cardiac surgery

Intramuscular stimulation as a novel alternative method of pain management after thoracic surgery

Uso del parche de lidocaína al 5 % para el tratamiento del dolor postquirúrgico en cirugía de tórax

Contact Info

Product

Resources

About