A Prospective Randomized Observer-Blinded Study to Assess Postoperative Analgesia Provided by an Ultrasound-Guided Bilateral Thoracic Paravertebral Block for Children Undergoing the Nuss Procedure

Qi, J.; Du, Bin; Gurnaney, Harshad; Lu, Peilin; Zuo, Yunxia

doi:10.1097/aap.0000000000000071

Cited by 40 publications

(30 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, these blocks are often underutilized despite potential benefits with regard to patient outcomes. Qi et al30 evaluated the effectiveness of an ultrasound-guided bilateral thoracic paravertebral block for postoperative pain control in children undergoing the Nuss procedure, and showed that the ultrasound-guided bilateral thoracic paravertebral block improved postoperative analgesia compared with PCIA and decreased the incidence of postoperative behavioral disturbance. The use of ultrasound guidance provides real-time information about the needle tip location and local anesthetic delivery to the desired location,31 which has also been demonstrated to improve success rates for ilioinguinal and transversus abdominis plane blocks, decrease the volume of local anesthetic solution, and avoid inadvertent needle trauma to surrounding structures 12,32.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ultrasonography-guided Bilateral Intercostal Nerve Blocks and Conventional Patient-controlled Intravenous Analgesia for Pain Control After the Nuss Procedure in Children

Luo

Liu²,

Li³

et al. 2017

The Clinical Journal of Pain

View full text Add to dashboard Cite

Objectives:Patients experience severe pain after pectus excavatum (PE) surgery. The aim of this prospective, randomized study was to compare analgesic effects of ultrasonography-guided bilateral intercostal nerve blocks (UG-ICNBs) with those of conventional patient-controlled intravenous analgesia (PCIA) on acute pain after the Nuss procedure for PE repair in children.Methods:A prospective randomized study was performed in children with PE who were scheduled for the Nuss procedure. Participants were randomly assigned to receive either UG-ICNBs or PCIA for postoperative analgesia. Faces Pain Scale-Revised scores, opioid consumption, analgesia-associated side effects (respiratory depression, pruritus, nausea, vomiting) during the first 24 hours, and lengths of stay in the postanesthesia care unit (PACU) and hospital were recorded after the surgery.Results:Sixty-two children undergoing the Nuss procedure were enrolled in the trial. Faces Pain Scale-Revised scores were significantly decreased in the UG-ICNBs group compared with the PCIA group for up to 6 hours after surgery. The opioid doses required in the PACU and during the first 24 hours after surgery were significantly greater in the PCIA group compared with the UG-ICNBs group. Accordingly, patients in the UG-ICNBs group showed a lower incidence of analgesia-associated side effects and faster PACU discharge compared with the PCIA group.Conclusions:Our study suggests that UG-ICNBs might be more effective than PCIA for postoperative analgesia in children who undergo the Nuss procedure for PE.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of Ultrasonography-guided Bilateral Intercostal Nerve Blocks and Conventional Patient-controlled Intravenous Analgesia for Pain Control After the Nuss Procedure in Children

Luo

Liu²,

Li³

et al. 2017

The Clinical Journal of Pain

View full text Add to dashboard Cite

show abstract

“…It contains six domains: general anxiety, aggression toward authority, separation anxiety, eating disturbance, sleep anxiety, apathy, and withdrawal. In our study, we used the translated version of the PHBQ, which has been widely used in research . We scored the PHBQ using two methods .…”

Section: Methodsmentioning

confidence: 99%

Postoperative behavioral changes in Chinese children undergoing hypospadias repair surgery: A prospective cohort study

Luo

Zuo

Liu

et al. 2018

Pediatric Anesthesia

Self Cite

View full text Add to dashboard Cite

Summary Background The perioperative period can be psychologically challenging, and children may exhibit behavioral changes following surgical anesthesia. It is unknown whether children in China have additional risk factors associated with negative behavioral changes. Objectives The aim of this study was to investigate the incidence of behavioral changes in children after hypospadias repair surgery and to identify potential risk factors associated with negative behavioral changes. Methods A prospective cohort of 177 children aged 2‐12 years scheduled for hypospadias repair surgery from 2016 to 2017 was studied. The primary outcome was the incidence of behavioral changes on postoperative days 14 and 30 evaluated with the Post‐Hospitalization Behavioral Questionnaire. Data collected included demographic data, anesthesia details, procedure details, admission details, child anxiety, child temperament, pain, and emergence delirium. Multivariable logistic regression was used to identify risk factors associated with postoperative negative behavioral changes. Results A total of 60.5% (107/177) of children exhibited negative postoperative behavioral changes on day 14 and 46.5% (79/170) exhibited changes on day 30 after the surgery. Approximately 2.3% (4/177) and 2.4% (4/170) of children showed improved behavior on postoperative days 14 and 30, respectively. The frequency of temper tantrums changed the most. The logistic regression results suggested that a younger age (odds ratio: 0.86; 95% confidence interval 0.76‐0.96), emotional temperament (odds ratio: 1.1; 95% confidence interval 1.0‐1.2) and maternal education (odds ratio: 2.2; 95% confidence interval 1.1‐4.5) were associated with negative postoperative behavioral changes on day 14. On day 30, a younger age (odds ratio: 0.87; 95% confidence interval 0.77 to 0.98) was the only factor associated with negative postoperative behavioral changes. Conclusion For children undergoing hypospadias repair surgery in our institution, approximately three in five showed postoperative behavioral changes. In addition to a younger age and a higher maternal education, an emotional temperament is associated with a high incidence of negative postoperative behavioral changes.

show abstract

“…No complications from placing TPVBs were noted in the study. They concluded that ultrasound-guided bilateral TPVBs provide improved postoperative analgesia for children undergoing the Nuss procedure as compared with intravenous parent-controlled intravenous analgesia and decreased the incidence of postoperative behavioral disturbance [17].…”

Section: Thoracic Paravertebral Blocks For Pectus Excavatum Repairmentioning

confidence: 99%

Update on paravertebral blocks

Wardhan¹

2015

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

show abstract

A Prospective Randomized Observer-Blinded Study to Assess Postoperative Analgesia Provided by an Ultrasound-Guided Bilateral Thoracic Paravertebral Block for Children Undergoing the Nuss Procedure

Abstract: Ultrasound-guided BTPV block provides improved postoperative analgesia for children undergoing the Nuss procedure as compared with intravenous PCA and decreases the incidence of postoperative behavioral disturbance.

Cited by 40 publications

References 24 publications

Comparison of Ultrasonography-guided Bilateral Intercostal Nerve Blocks and Conventional Patient-controlled Intravenous Analgesia for Pain Control After the Nuss Procedure in Children

Comparison of Ultrasonography-guided Bilateral Intercostal Nerve Blocks and Conventional Patient-controlled Intravenous Analgesia for Pain Control After the Nuss Procedure in Children

Postoperative behavioral changes in Chinese children undergoing hypospadias repair surgery: A prospective cohort study

Update on paravertebral blocks

Contact Info

Product

Resources

About