Thoracic paravertebral block for postoperative pain management after renal surgery

Copik, Maja; Białka, Szymon; Daszkiewicz, Andrzej; Misiołek, Hanna

doi:10.1097/eja.0000000000000673

Cited by 23 publications

(18 citation statements)

References 19 publications

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“…Several strategies, including local and regional anesthesia, are now performed as core components of multimodal analgesia for postoperative pain 3–5. Ultrasound-guided erector spinae plane block (ESPB) is a novel interfacial plane block first introduced by Forero et al 6 for pain control.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial

Yao

et al. 2019

Reg Anesth Pain Med

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BackgroundErector spinae plane block (ESPB) is a novel regional anesthesia technique that is gaining popularity for postoperative pain management. This randomized controlled trial evaluated the effect of ESPB on quality of recovery (QoR) in patients undergoing modified radical mastectomy.MethodsEighty-two female patients undergoing modified radical mastectomy were included. Patients were randomly assigned to receive preoperative ultrasound-guided ESPB with either 0.5% ropivacaine or saline. The primary outcome was QoR, assessed 24 hours postoperatively using the 15-item QoR questionnaire (QoR-15). Secondary outcomes included postoperative pain scores, postoperative cumulative opioid consumption, postanesthesia care unit (PACU) discharge time, postoperative nausea or vomiting and dizziness.ResultsGlobal QoR-15 scores 24 hours postoperatively were significantly higher (indicating better quality) in the ESPB group (median 120, IQR 118–124) compared with the control group (median 110, IQR 108.3–112.8), with a median difference of 10 (95% CI 9 to 12, p<0.001). Compared with the control group, ESPB with ropivacaine reduced pain scores up to 8 hours after surgery, as well as reduced postoperative cumulative opioid consumption and PACU discharge time.ConclusionsA single preoperative injection of ESPB with ropivacaine may improve QoR postoperatively and acute postoperative analgesia in patients undergoing a modified radical mastectomy.Trial registration numberChiCTR-1800019599.

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Section: Introductionmentioning

confidence: 99%

Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial

Yao

et al. 2019

Reg Anesth Pain Med

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“…Both caudal thoracic and cranial lumbar dorsal root ganglia reach the majority of the abdominal viscera via the thoracic sympathetic chain and the peripheral plexuses (Cervero, 1994). In human anesthesia, the use of TPV catheters has been shown to provide effective analgesia for the pain management in the postoperative period (Copic et al, 2017;Liu et al, 2017). An ultrasound (US)-guided TPV block technique has recently been described in Canidae at the level of the 5th thoracic vertebrae (Monticelli et al, 2017;Portela http://www.openveterinaryjournal.com R. M. Serra et al Open Veterinary Journal, (2019), Vol.…”

Section: Introductionmentioning

confidence: 99%

Assessment of an ultrasound-guided technique for catheterization of the caudal thoracic paravertebral space in dog cadavers

Serra¹,

Jiménez²,

Monticelli³

et al. 2019

Open Vet J.

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Background: The caudal thoracic paravertebral (CTPV) block is a regional anesthesia technique currently used in human medicine to provide analgesia in abdominal surgical procedures. Aim: The objectives of this study are to describe an ultrasound-guided technique to place catheters in CTPV space in canine cadavers and evaluate the distribution of a 50:50 contrast-dye solution administered through them. Methods: Eight thawed adult beagle cadavers (9.2 ± 2.0 kg body total weight) were used. Thirteen catheters were placed. In the first phase, a volume of 0.3 ml kg −1 of the contrast-dye was administered in all cases. After the injections, computed tomography (CT) scans were carried out to assess the distribution of the contrast-dye. In the second phase, an extra 0.2 ml kg −1 of the contrast-dye was administered through eight catheters, followed by a second CT scan. Two cadavers were dissected to assess the distribution of the contrast-dye. The injection site varied between T8-9 and T12-13. Results: The evaluation of the CT scans showed contrast-dye within the paravertebral space in 92% (12/13) of the injections. The distribution pattern observed after the injections performed within the TPV space was linear and intercostal in all cases. The median (range) linear spread of the contrast was 7 (5-10) spinal nerves and involved 3 (2-8) intercostal spaces. The contrast-dye reached lumbar regions in 42% of the injections (5/12). A larger spread of the contrast-dye was not observed after the administration of a second dose of the injectate. No signs of epidural, intrapleural/intrapulmonary, intravascular, or intraabdominal spread were observed. The dissection of the two cadavers confirmed the spread of the contrast-dye along the sympathetic trunk and intercostal spaces. Conclusion: The administration of 0.3 ml kg −1 of the contrast-dye in the CTPV space resulted in a distribution compatible with the block of nerves responsible for the innervation of the majority of the abdominal viscera and cranial abdominal wall.

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“…However, compared with group C, the scores both at rest and at coughing were still lower in group T after 72 hours; this phenomenon is consistent with the findings of other authors who successfully used PSTPVB with different surgical procedures. [ 8 , 9 , 11 ] The possible reasons for this phenomenon may be explained as follows:…”

Section: Discussionmentioning

confidence: 99%

“…The relatively sparse vascularity of the paravertebral space [ 11 ] : The vascularity has an impact on local anesthetics uptake and removal. Reduced vascularity can slow the removal of drug and thus prolong the duration of action.…”

Section: Discussionmentioning

confidence: 99%

The effects of preoperative single-dose thoracic paravertebral block on acute and chronic pain after thoracotomy

Zhang²,

Dai³

et al. 2018

Medicine

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Background:Patients undergoing thoracotomy frequently experience acute pain and chronic post-thoracotomy pain (CPTP). There are few articles relating to the investigations on the effects of preoperative single-dose thoracic paravertebral block (PSTPVB) on acute pain and CPTP. We tested the hypothesis that adding PSTPVB to intravenous (IV) patient-controlled analgesia (PCA) would reduce acute pain scores and decrease the incidence and intensity of CPTP.Methods:Fifty-six patients undergoing elective thoracotomy were randomized to receive PSTPVB in addition to IV PCA (group T) or IV PCA alone (group C). A single 20-mL injection of 0.50% ropivacaine plus 10 mg dexamethasone in saline was administered preoperatively under ultrasound guidance; sufentanil was used for IV PCA. The acute pain intensity at rest and at coughing based on verbal rating scale, postoperative sufentanil consumption, and complications were evaluated at 6, 24, 48, and 72 hours after surgery. The incidence and intensity of CPTP were evaluated at 3 months after surgery.Results:Group T had significantly less acute pain compared with group C at all measurement times both at rest and at coughing (P < .05). The PCA cumulative sufentanil consumption, complications, and the incidence of CPTP between the 2 groups was not statistically significant (P > .05). The intensity of CPTP was significantly higher in group C than in group T (P < .05).Conclusion:This study indicated that adding PSTPVB to IV PCA improved acute postoperative pain and chronic pain in patients undergoing thoracotomy, but did not reduce the incidence of CPTP.

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Thoracic paravertebral block for postoperative pain management after renal surgery

Abstract: Clinical Trials NCT02840526.

Cited by 23 publications

References 19 publications

Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial

Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial

Assessment of an ultrasound-guided technique for catheterization of the caudal thoracic paravertebral space in dog cadavers

The effects of preoperative single-dose thoracic paravertebral block on acute and chronic pain after thoracotomy

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