Paravertebral Nerve Block for Procedural Pain in Percutaneous Vertebroplasty

Abstract

Objectives: This study aimed to unidimensionally measure procedural pain at each percutaneous vertebroplasty (PVP) stage and evaluate the effectiveness of paravertebral nerve block (PVNB) in reducing procedural pain. Methods: A retrospective study of prospectively collected data was conducted on 66 patients who underwent PVP for osteoporotic vertebral compression fractures. The subjects were divided into two groups: Group A (fluoroscopic-guided PVNB; 5 cm3 of 0.75% ropivacaine on each side) and Group B (local anesthesia). To investigate procedural pain associated with PVP, the visual analog scale (VAS) score was assessed at each surgical stage: before the incision (stage 1), transpedicular approach (stage 2), and polymethylmethacrylate cement injection (stage 3). After the procedure, patients were asked about their surgical experience and satisfaction using the IOWA Satisfaction with Anesthesia Scale (ISAS). Periprocedural complications were also recorded. Results: A total of 63 patients (78.65 y of age) were finally enrolled: 30 from group A and 33 from group B. In both groups, a significant ≥2-point increase in procedural pain was observed during PVP compared to that during stage 1 (P<0.001). In stages 2 and 3, the pain intensity was significantly lower in Group A (P<0.001). Upon discharge, the VAS score improved in all groups; however, the ISAS score was significantly higher in Group A (P<0.001). There was no difference in periprocedural complications between the two groups (P=0.743). Discussion: PVP causes significant procedural pain, and PVNB is a potentially effective modality for enhancing patient satisfaction and reducing procedural pain.