Comparison of the analgesic effects of modified continuous intercostal block and paravertebral block under surgeon’s direct vision after video-assisted thoracic surgery: a randomized clinical trial

Kadomatsu, Yuka; Mori, Satoshi; Ueno, H.; Uchiyama, Mineto; Wakai, Kenji

doi:10.1007/s11748-018-0936-8

Cited by 21 publications

(46 citation statements)

References 27 publications

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“…In addition, two studies which are not RCTs were also excluded. Finally, the remaining 9 studies [13][14][15][16][17][18][19][20][21] were included in our systematic review and meta-analysis. The strategy of the research and the process of the selection were shown in the flow diagram of…”

Section: Identification Of Eligible Studies Characteristics Of the Stmentioning

confidence: 99%

“…Although there was no heterogeneity in above analysis, we still performed the subgroup analysis to investigate that whether the VAS at rest at 48h was influenced by the use of opioid drug or NSAIDs. After excluding the study using NSAIDs Kadomatsu (2018) [17], there was also no heterogeneity in the subgroup (I 2 = 0%, heterogeneity P = 0.44) and there was no significant difference between Opioid drug and NSAIDs and INB (Std. MD = -0.05; 95% CI = -0.20 to 0.11; P = 0.56) (Fig 15).…”

Section: Plos Onementioning

confidence: 99%

“…Kadomatsu (2018), Hutchins (2017), Chen (2014) and Perttunen (1995) [14,[16][17][18][19]21]. All in all, the rates of PONV in the PVB and INB groups were 26.5% and 36.2%, respectively.…”

Section: Plos Onementioning

confidence: 99%

“…More and more published studies compared PVB with INB in terms of the VAS and complications [13][14][15][16][17][18][19][20][21]. But these articles were not well-integrated and the results of them have been found contradictory and unconvincing.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis

et al. 2020

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Objective To evaluate the analgesic efficacy and safety of paravertebral block (PVB) versus intercostal nerve block (INB) in thoracic surgery and breast surgery. Methods The PubMed, Web of Science, Embase and the Cochrane Library were searched up to February 2020 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy and safety of PVB compared with INB after thoracic surgery and breast surgery. For binary variables, odds ratio (OR) and 95% confidence interval (CI) was used. For continuous variables, weighted mean difference (WMD) and 95% confidence interval (CI) were used. RevMan5. 3 and Stata/MP 14.0 were used for performing the meta-analysis. Results A total of 9 trials including 440 patients (PVB block:222 patients; INB: 218 patients) met the inclusion criteria. In the primary outcome, there was no significant differences between the two groups with respect to postoperative visual analogue scale (VAS) at 1h (Std. MD =-0. 20; 95% CI =-1. 11to 0. 71; P = 0. 66), 2h (Std. MD =-0. 71; 95% CI =-2. 32to 0. 91; P = 0. 39), 24h (Std. MD =-0. 36; 95% CI =-0. 73 to-0. 00; P = 0. 05) and 48h (Std. MD =-0. 04; 95% CI =-0. 20 to 0. 11; P = 0. 57). However, there was significant difference in VAS of non Chinese subgroup at 1h (Std. MD = 0. 33; 95% CI = 0. 25to 0. 41; P<0. 00001) and VAS of Chinese subgroup at 24h (Std. MD =-0.32; 95% CI =-0.49 to-0.14; P = 0.0003). In the secondary outcome, the analysis also showed no significant difference between the groups according to the rates of postoperative nausea and vomit (OR = 0. 63; 95% CI = 0. 38 to 1.

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Section: Identification Of Eligible Studies Characteristics Of the Stmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

“…Kadomatsu (2018), Hutchins (2017), Chen (2014) and Perttunen (1995) [14,[16][17][18][19]21]. All in all, the rates of PONV in the PVB and INB groups were 26.5% and 36.2%, respectively.…”

Section: Plos Onementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis

et al. 2020

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“…La inserci on de catéter paravertebral por parte del cirujano durante el procedimiento (BPV-C) se realiz o en 18 estudios, 11,[16][17][18][34][35][36][37][38][39][40][41][42][43][44][45][46][47] siendo esta la técnica de BPV más representativa, al ser evaluada en el 46 % de los estudios incluidos en la revisi on. Este tipo de abordaje fue el que mayor variaci on tuvo a través de los estudios incluidos, dado que la técnica de punci on cambi o de manera sustancial de acuerdo con el grado de visualizaci on quir urgica del cirujano durante el procedimiento quir urgico; adicionalmente, los momentos del bloqueo fueron altamente inconsistentes, dado que en algunos estudios este se realiz o al inicio de la cirugía, en otros antes de la toracotomía (mediante toracoscopia previa para su colocaci on) 25,26,28,34,48 y en otros al finalizar el procedimiento quir urgico.…”

Section: Características De Los Estudiosunclassified

Efficacy of paravertebral block techniques in thoracic surgery

Cadavid-Puentes

Casas-Arroyave

Palacio-Montoya

et al. 2020

Colombian Journal of Anesthesiology

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ResumenIntroducci on: El dolor posoperatorio en cirugía de t orax en adultos usualmente es grave, y para su control existen varios métodos analgésicos que incluyen el bloqueo paravertebral (BPV). En la actualidad no hay claridad acerca de la técnica más efectiva para su realizaci on.Objetivo: Describir las diferentes técnicas de colocaci on del BPV y su efecto en el control analgésico en cirugía de t orax. Métodos: Se realiz o una revisi on sistemática de la literatura. Se incluyeron estudios que analizaron pacientes sometidos a cirugía de t orax abierta y que utilizaron el BPV como técnica analgésica. Se emplearon las estrategias Cochrane y GRADE (Grading of Recommendation Assessment, Development and Evaluation) para valorar la evidencia disponible. Se presentan los resultados de manera gráfica mediante escala visual análoga de dolor y consumo de opioide equivalente a morfina para cada técnica encontrada. Se realiz o síntesis cualitativa de los resultados sin metanálisis. Resultados: Se analizaron en total 38 artículos (2188 pacientes). 13 estudios usaban BPV guiado por anatomía de superficie (BPV-AS), 7 BPV con guía ecográfica (BPV-US), 1 BPV guiado por neuroestimulaci on (BPV-NE) y los restantes BPV bajo visualizaci on directa por el cirujano (BPV-C). Se encontr o una escala visual análoga (EVA) menor a 3 en los estudios con BPV-AS y BPV-US y mayor a 5 en estudios con BPV-C; sin embargo, el consumo de opioides en el posoperatorio fue similar entre las técnicas descritas. Conclusi on: Se han descrito cuatro técnicas para la realizaci on del BPV. Las técnicas de BPV-US o BPV-AS han mostrado mejor consistencia para el manejo del dolor agudo posoperatorio en cirugía de t orax.Abstract Introduction: Postoperative pain in thoracic surgery in adults is usually severe, and to control it there are many analgesic methods that include paravertebral blockade (PVB). Until now, there is no clarity on which is the most effective technique to perform this blockade. Objective: To describe the different PVB techniques and its analgesic effect in thoracic surgery. C omo citar este artículo: Cadavid-Puentes AM, Casas-Arroyave FD, Palacio-Montoya LM, Valencia-Gall on E. Efficacy of paravertebral block techniques in thoracic surgery: systematic literature review.

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Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery

et al. 2021

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IMPORTANCEThe use of intercostal nerve block (ICNB) analgesia with local anesthesia is common in thoracic surgery. However, the benefits and safety of ICNB among adult patients undergoing surgery is unknown. OBJECTIVE To evaluate the analgesic benefits and safety of ICNB among adults undergoing thoracic surgery.DATA SOURCES A systematic search was performed in Ovid MEDLINE, Ovid Embase, Scopus, and the Cochrane Library databases using terms for ICNB and thoracic surgery (including thoracic surgery, thoracoscopy, thoracotomy, nerve block, intercostal nerves). The search and results were not limited by date, with the last search conducted on July 24, 2020.STUDY SELECTION Selected studies were experimental or observational and included adult patients undergoing cardiothoracic surgery in which ICNB was administered with local anesthesia via single injection, continuous infusion, or a combination of both techniques in at least 1 group of patients. For comparison with ICNB, studies that examined systemic analgesia and different forms of regional analgesia (such as thoracic epidural analgesia [TEA], paravertebral block [PVB], and other techniques) were included. These criteria were applied independently by 2 authors, and discrepancies were resolved by consensus. A total of 694 records were selected for screening. DATA EXTRACTION AND SYNTHESIS This study followed the Preferred Reporting Items forSystematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data including patient characteristics, type of surgery, intervention analgesia, comparison analgesia, and primary and secondary outcomes were extracted independently by 3 authors. Synthesis was performed using a fixed-effects model. MAIN OUTCOMES AND MEASURESThe coprimary outcomes were postoperative pain intensity (measured as the worst static or dynamic pain using a validated 10-point scale, with 0 indicating no pain and 10 indicating severe pain) and opioid consumption (measured in morphine milligram equivalents [MMEs]) at prespecified intervals (0-6 hours, 7-24 hours, 25-48 hours, 49-72 hours, and >72 hours). Clinically relevant analgesia was defined as a 1-point or greater difference in pain intensity score at any interval. Secondary outcomes included 30-day postoperative complications and pulmonary function. RESULTSOf 694 records screened, 608 were excluded based on prespecified exclusion criteria.The remaining 86 full-text articles were assessed for eligibility, and 20 of those articles were excluded. All of the 66 remaining studies (5184 patients; mean [SD] age, 53.9 [10.2] years; approximately 59% men and 41% women) were included in the qualitative analysis, and 59 studies (continued)

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Comparison of the analgesic effects of modified continuous intercostal block and paravertebral block under surgeon’s direct vision after video-assisted thoracic surgery: a randomized clinical trial

Abstract: Our results could not clearly establish noninferiority of ICB to PVB. Improvements in ICB may be necessary for it to be used as an alternative method to PVB.

Cited by 21 publications

References 27 publications

Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis

Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis

Efficacy of paravertebral block techniques in thoracic surgery

Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery

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