Epidural Versus Paravertebral Nerve Block for Postoperative Analgesia in Patients Undergoing Open Liver Resection

Schreiber, Kristin L.; Chelly, Jacques E.; Lang, Robert Scott; Abuelkasem, Ezeldeen; Geller, David A.; Marsh, J. Wallis; Tsung, Allan; Sakai, Tetsuro

doi:10.1097/aap.0000000000000422

Cited by 26 publications

(23 citation statements)

References 23 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although many studies found that unilateral TPVB produced similar analgesia efficacy as compared with epidural block for thoracic surgery, a few studies have yet been compared bilateral TPVB with epidural analgesia for laparotomy which is generally considered to be a standard approach for postoperative pain relief after laparotomy. Recently Schreiber et al found that there was modest analgesic advantage of thoracic epidural over bilateral TPVB for participants after open liver resection [18]. However, as the author also pointed out, technical risk and rare but serious complications such as epidural hematoma, perioperative hypotension related to epidural block can not be ignored.…”

Section: Discussionmentioning

confidence: 99%

Bilateral thoracic Paravertebral block for immediate postoperative pain relief in the PACU: a prospective, observational study

2017

View full text Add to dashboard Cite

BackgroundTo investigate the feasibility, effectiveness and safety of bilateral thoracic paravertebral block (TPVB) in the post anesthesia care unit (PACU) for pain relief in participants after laparotomy.MethodsA single shot of bilateral TPVB with 25 ml of 0.2% ropivacaine and 5 mg dexamethasone in combination for both sides at the 8th thoracic transverse level (T8) was performed on 201 participants who complained moderate to severe pain on arrival to PACU after laparotomy. The visual analog scale (VAS) pain scores at rest and on cough, heart rate, blood pressure, and pulse oximetry before and after bilateral TPVB for up to 1 h were recorded. The VAS Pain scores at rest and on cough at 24 h after bilateral TPVB were also recorded.ResultsBilateral TPVB was carried out successfully in all participants. The VAS pain scores at rest and on cough were 7.9 ± 1.6 and 8.7 ± 1.3 respectively pre-bilateral TPVB. The VAS pain scores at rest and on cough were significantly decreased to 1.1 ± 1.2 and 2.1 ± 1.6 respectively (P < 0.001) at 60 min after bilateral TPVB and to 2.1 ± 1.7 and 3.8 ± 1.9 at rest and on cough respectively ((P < 0.001) at 24 h after bilateral TPVB. At 10 min post-bilateral TPVB, only systolic blood pressure was reduced from 122 ± 19 mmHg to 111 ± 18 mmHg (P = 0.007) but then gradually became stable. No complications related to bilateral TPVB were observed.ConclusionBilateral TPVB can be provided for pain relief to the participants who suffer from moderate to severe pain after upper laparotomy in the PACU.Trial registrationChinese Clinical Trial Registry: ChiCTR-ONN-16009229, Registered on 10 September 2016.

show abstract

Section: Discussionmentioning

confidence: 99%

Bilateral thoracic Paravertebral block for immediate postoperative pain relief in the PACU: a prospective, observational study

2017

View full text Add to dashboard Cite

show abstract

“…After detailed evaluation, 12 articles containing 661 patients satisfied the study recruitment criteria (Fig. , Table ).…”

Section: Resultsmentioning

confidence: 99%

Most effective pain‐control procedure for open liver surgery: a network meta‐analysis

Zhou

Huang

Chen

2018

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Using elastomeric pain pump devices for analgesia, after hernia repair has not been shown to significantly decrease pain, opioid consumption, or length of hospital stay . Epidural analgesia has been shown to provide good postoperative pain relief both after open liver resection and live liver donation . The use of epidural analgesia for postoperative pain control has also been found to reduce total opioid consumption.…”

Section: Discussionmentioning

confidence: 99%

Pain interventions for organ transplant patients undergoing incisional hernia repair: Is epidural or transversus abdominus plane block a better option?

Yeap

Wolfe

Fridell

et al. 2018

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

Epidural Versus Paravertebral Nerve Block for Postoperative Analgesia in Patients Undergoing Open Liver Resection

Abstract: This study suggests that there is a modest analgesic advantage of thoracic epidural over bTPVBs for patients after open liver resection.

Cited by 26 publications

References 23 publications

Bilateral thoracic Paravertebral block for immediate postoperative pain relief in the PACU: a prospective, observational study

Bilateral thoracic Paravertebral block for immediate postoperative pain relief in the PACU: a prospective, observational study

Most effective pain‐control procedure for open liver surgery: a network meta‐analysis

Pain interventions for organ transplant patients undergoing incisional hernia repair: Is epidural or transversus abdominus plane block a better option?

Contact Info

Product

Resources

About