Effect of ultrasound‐guided thoracic paravertebral block on perioperative analgesia in elderly patients undergoing video‐assisted thoracic lobectomy in China: An interventional clinical randomized controlled trial

Gong, Chanjuan; Ma, Rong; Li, Bing; Wen, Li; Ding, Zhengnian

doi:10.1111/1759-7714.15135

Cited by 3 publications

(1 citation statement)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To ensure the effectiveness and safety of postoperative analgesia, TPVB was performed by the same experienced anesthesiologists under the guidance of ultrasound. Numerous studies have confirmed that TPVB can reduce postoperative acute pain, mainly caused by the chest drain and opioid sparing after thoracic surgery [21,22]. One previous study showed that general anesthesia combined with TPVB can reduce postoperative pulmonary complications by reducing postoperative pain in geriatric patients undergoing thoracic surgery [23].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of postoperative analgesia with intravenous paracetamol and mannitol injection, combined with thoracic paravertebral nerve block in post video-assisted thoracoscopic surgery pain: a prospective, randomized, double-blind controlled trial

Zhou,

Yuan,

Xing

et al. 2024

BMC Anesthesiol

View full text Add to dashboard Cite

Background Although video-assisted thoracoscopic surgery (VATS) has advantages of reduced injury and faster healing, patients still endure moderate and severe postoperative pain. Paracetamol and mannitol injection, the first acetaminophen injection in China, has the advantages of convenient administration, rapid onset of action, and no first-pass effect. This aim of this study was to investigate the efficacy of postoperative analgesia with paracetamol and mannitol injection, combined with thoracic paravertebral nerve block (TPVB) in post VATS pain. Methods This study was a single-center, prospective, randomized, double-blind controlled clinical trial. Patients scheduled for VATS were randomly divided into three groups, general anesthesia group (Group C), TPVB group (Group T) and TPVB + paracetamol and mannitol injection group (Group TP). In this study, the primary outcome was determined as visual analog scale (VAS) scores at rest and coughing, the secondary observation outcomes were the first time to use analgesic pump, the total consumption of oxycodone in the analgesic pump, number of effective and total analgesic pump compressions at first 48 h postoperatively, the perioperative consumption of sufentanil, time to extubation, hospital length of stay, urine volume, and the incidence of adverse events. Results In a state of rest and cough, patients in the Group TP showed significantly lower VAS pain scores at 1, 12, 24, and 48 postoperative-hour compared with Group C and Group T. Intraoperative sufentanil and postoperative oxycodone consumption, the first time to press analgesic pump, the times of effective and total compressions of patient- controlled analgesia (PCA) were lower than those of the Group C and Group T. Interestingly, urine output was higher in Group TP. There were no differences between the three groups in terms of extubation time, length of hospital stay and adverse effects, indicating that intravenous paracetamol and mannitol injection is an effective and safe perioperative analgesia method. Conclusions Paracetamol and mannitol injection, combined with TPVB may provide important beneficial effects on acute pain control and reduce the consumption of opioid in patients undergoing VATS. Trial registration The trial was registered on Jun 19, 2023 in the Chinese Clinical Trial Registry (https://www.chictr.org.cn/showproj.html?proj=199315), registration number ChiCTR2300072623 (19/06/2023).

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of postoperative analgesia with intravenous paracetamol and mannitol injection, combined with thoracic paravertebral nerve block in post video-assisted thoracoscopic surgery pain: a prospective, randomized, double-blind controlled trial

Zhou,

Yuan,

Xing

et al. 2024

BMC Anesthesiol

View full text Add to dashboard Cite

show abstract

Pro's and con's of different blocks for postoperative analgesia after video-assisted thoracic surgery

Karakaya,

Yapici,

Bingül

et al. 2024

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

Purpose of review Although there are a lot of studies examining the effects of different blocks for postoperative analgesia after video-assisted thoracic surgery (VATS), the results are controversial. Recent findings Paravertebral block, serratus anterior plane block and erector spinae plane block appear to be effective and beneficial for post-VATS analgesia, but probably in different manners. Summary All three blocks can be suggested for daily practice, the choice should be based on personal experience and preference of the anesthetist. Better studies are required for objective decision.

show abstract

Adding Dexmedetomidine to Methylene Blue in Thoracic Paravertebral Block for Video-Assisted Lobectomy: A Case Series Study

Coppolino,

Brunetti,

Bottazzo

et al. 2024

LRA

View full text Add to dashboard Cite

Purpose Thoracic surgery often results in severe chronic postoperative pain. Current evidence favors two locoregional techniques. Thoracic Epidural Anesthesia (TEA), the gold standard, and Thoracic Paravertebral Block (TPVB), which is associated with fewer side effects but is limited by short duration of action of local anesthetics (LA) and potential failure due to improper drug distribution. This study investigates the use of dexmedetomidine (DEX) as adjuvant to prolong the effects of LA in TPVB, with methylene blue used for visual confirmation of accurate injectate spread. Patients and Methods We observed 6 patients undergoing Video-Assisted Thoracoscopy (VATS) lobectomy who received TPVB with ropivacaine, DEX and methylene blue. The primary endpoint was postoperative pain recorded at 1, 12, 24, 48 hours using Numeric Rating Scale (NRS); the secondary endpoints were cumulative opioid consumption in the first 24 hours in Milligram Morphine Equivalents (MME); adverse events: occurrence of bradycardia, hypotension, Postoperative Nausea and Vomiting (PONV); length of hospital stay. All patients completed the study. Results Our results showed optimal pain scores, with NRS scores always below 4, decreased need for opioids, and prolonged analgesia. None of the patients had bradycardia nor PONV, but two patients experienced acute and self-limited hypotension following TPVB. Conclusion Thoracic Paravertebral Block with Dexmedetomidine and methylene blue was effective and safe in controlling postoperative pain. Methylene blue could help improving knowledge on anesthetics distribution to reduce failure rates.

show abstract

Effect of ultrasound‐guided thoracic paravertebral block on perioperative analgesia in elderly patients undergoing video‐assisted thoracic lobectomy in China: An interventional clinical randomized controlled trial

Cited by 3 publications

References 28 publications

Efficacy of postoperative analgesia with intravenous paracetamol and mannitol injection, combined with thoracic paravertebral nerve block in post video-assisted thoracoscopic surgery pain: a prospective, randomized, double-blind controlled trial

Efficacy of postoperative analgesia with intravenous paracetamol and mannitol injection, combined with thoracic paravertebral nerve block in post video-assisted thoracoscopic surgery pain: a prospective, randomized, double-blind controlled trial

Pro's and con's of different blocks for postoperative analgesia after video-assisted thoracic surgery

Adding Dexmedetomidine to Methylene Blue in Thoracic Paravertebral Block for Video-Assisted Lobectomy: A Case Series Study

Contact Info

Product

Resources

About