Comparison of thoracic epidural analgesia and thoracic paravertebral block in pain management after thoracotomy

Zengin, Musa; Baldemir, Ramazan; Ulger, Gulay; Sazak, Hilal; Alagöz, Ali

doi:10.38053/acmj.1034690

Cited by 6 publications

(9 citation statements)

References 28 publications

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“…In studies comparing TPVB and TEA, side effects such as hypotension, nausea/vomiting, itching, urinary retention are more limited in TPVB applications (8,10). This circumstance can be explained by the limited sympathetic and neuraxial block due to TPVB.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Thoracic epidural analgesia (TEA) remains the gold standard in the treatment of postoperative pain in thoracic surgery (6)(7)(8). However, TEA may cause side effects such as hypotension, urinary retention, nausea, and vomiting (8,9). Therefore, in recent years, peripheral blocks have been preferred more for postoperative analgesia following VATS applications.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, in recent years, peripheral blocks have been preferred more for postoperative analgesia following VATS applications. There are also studies showing that peripheral blocks and TEA provide similar postoperative analgesia after VATS (7,8,10).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the effects of ultrasound-guided thoracic paravertebral block and erector spinae plane block on postoperative acute and chronic pain in patients undergoing video-assisted thoracoscopic surgery

Zengin

Ulger

Baldemir

et al. 2022

Journal of Health Sciences and Medicine

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Aim: The aim of the study was to compare the effects of ultrasound (US)-guided Erector spinae plane block (ESPB) and thoracic paravertebral block (TPVB) on postoperative acute and chronic pain. Material and Method: Patients aged range of 18 to 80 years and underwent video-assisted thoracoscopic surgery (VATS) were included in a single-blinded randomized trial. All patients were informed about the study and their written consent was obtained. The primary outcome was determined as acute postoperative visual analog scale (VAS) scores, and secondary outcomes were postoperative morphine consumption and the incidence of chronic pain. US-guided ESPB and TPVB were performed to all patients and they were assigned randomly to ESPB (Group 1) and TPVB (Group 2) groups according to the analgesia protocol. Results: Visual analog scale (VAS) resting and VAS cough scores at the 1st, 2nd, 4th, 8th, and 16th hours were found to be statistically significantly higher in the TPVB group than in the ESPB group (p<0.05) Morphine consumption (p:0.042) and additional analgesic (p:0.037) use were found to be statistically significantly higher in the TPVB group compared to the ESPB group. As complications, only nausea and vomiting were observed with no significant difference between the groups (p>0.05). There was no significant difference in terms of postoperative 30th and 90th day pain characteristics between the groups (p>0.05). Conclusion: ESPB was superior to TPVB in terms of acute postoperative pain management, morphine consumption, and side effects, but the incidence of chronic pain in the first and third months after surgery was similar in both groups.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of the effects of ultrasound-guided thoracic paravertebral block and erector spinae plane block on postoperative acute and chronic pain in patients undergoing video-assisted thoracoscopic surgery

Zengin

Ulger

Baldemir

et al. 2022

Journal of Health Sciences and Medicine

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“…In addition, maintaining hemodynamic stability and providing adequate depth of anesthesia with anesthetic drugs is more difficult in elderly ages due to possible pharmacokinetic and pharmacodynamic changes (11)(12)(13). Therefore, for these patients, preoperative evaluation is very important.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia management and challenges during interventional pulmonology procedures for central airway obstructions

Ulger

Sazak

Şener

et al. 2022

Anatolian Current Medical Journal

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Aim: Central airway obstructions (CAO) are one of the main reasons for morbidity and mortality, often originate in the lungs, and are generally unresectable. Interventional airway procedure is a preferred method in these cases. This study aimed to analyze anesthesia management in patients undergoing interventional procedures for CAO. We aimed to highlight the problem and solutions that may be encountered in such cases. Material and Method: The data of 49 patients who had interventional airway procedure were analyzed retrospectively. Patients’ demographic data, type of interventional procedures, localization of the lesion, and duration of the procedure were analyzed. Vital parameters and arterial blood gases (ABG) levels had been recorded before anesthesia induction (T1), after rigid bronchoscope insertion (T2), 20th-minute of the procedure (T3), after extubation (T4), and in the postoperative care unit (T5). Results: The mean age was 57.90±11.99 years. The mean duration of the procedure was 34.75±15.62 minutes. The majority of the patients had American Society of Anesthesiologists (ASA) III-IV physical status. CAOs were mostly found in the main bronchus. Tumors debulking, biopsy, mechanical dilatation, argon plasma coagulation, and mechanical tumor resection were the most performed procedures. Stent insertion was performed in 3 (6.1%) patients. Two patients (4.1%) had bleeding, 3 (6.1%) patients had desaturation, and 1 (2.1%) patient had atrial fibrillation. Conclusion: Interventional airway procedures are frequently used for high risk patients with CAO and comorbidities. Detailed preoperative evaluation, periprocedural teamwork, and close hemodynamic and ABG follow-up are keys to success.

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Comparison of Four Different Block Techniques for Postoperative Analgesia in Thoracotomy

Arslan

2024

GKDA Derg

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Objectives: Postthoracotomy pain requires multimodal perioperative management, including systemic and regional techniques. This prospective, randomized study aimed to evaluate postthoracotomy pain scores using the visual analog scale (VAS) as well as consumption of analgesic in 24 h and complications. Methods: The patients were randomly assigned into four groups (25 patients each group) according to the analgesia technique used: Intercostal nerve block (ICB), thoracic epidural block (TEB), ultrasonography-guided erector spinae plane block (ESPB), and ultrasonography-guided thoracic paravertebral block (TPVB) groups. Multimodal analgesia was achieved with tramadol, paracetamol, and intravenous pethidine via patient-controlled analgesia (PCA) for all patients. The VAS scores at 30, 60, 90, 120 min, 6, 12, and 24 h postoperatively, consumption of analgesic at the first 24 h, rescue analgesic requirement, and side effects were recorded. Results: The VAS scores were the highest in the ICB group and the lowest in the TPVB group at all time periods after thoracotomy (p<0.05). Likewise, total pethidine dose, number of PCA trials, and PCA data were determined to be at least in the TPVB group. However, only the number of PCA trials was found to be statistically significant (p=0.03). In terms of side effects, no difference was observed between the groups. Nausea and vomiting occurred in two patients in the ICB and ESPB groups, whereas hypotension occurred in two patients in the TEB group. Conclusion:In conclusion, ultrasound-guided single-injection TPVB is more reliable and preferable in thoracotomy, as it is associated with low pain scores and has no side effects.

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Comparison of thoracic epidural analgesia and thoracic paravertebral block in pain management after thoracotomy

Cited by 6 publications

References 28 publications

Comparison of the effects of ultrasound-guided thoracic paravertebral block and erector spinae plane block on postoperative acute and chronic pain in patients undergoing video-assisted thoracoscopic surgery

Comparison of the effects of ultrasound-guided thoracic paravertebral block and erector spinae plane block on postoperative acute and chronic pain in patients undergoing video-assisted thoracoscopic surgery

Anesthesia management and challenges during interventional pulmonology procedures for central airway obstructions

Comparison of Four Different Block Techniques for Postoperative Analgesia in Thoracotomy

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