Single Dose Preemptive Thoracic Paravertebral Block For Postoperative Pain Relief After Cholecystectomy

نویسندگان

  • Tarek Atef Tawfic
  • Mohamed Medhat Khalil
چکیده

The controversy over pre-emptive analgesia continues unabated, with studies both supporting and refuting its efficacy. Forty patients undergoing elective open cholecystectomy were randomized into two equal groups (20 patients each) to either pre-emptive thoracic bolus paravertebral block (PVB) with ropivacaine 0.5% (20 ml), before surgical incision (group I) or to receive the same block after termination of surgery (group II). The objective of this work is to evaluate thoracic PVB for pain control after open cholecystectomy and to compare its effects when given either before surgical incision or after termination of surgery. No differences in the postoperative pain scores were depicted, although the pre-emptive thoracic PVB offered a good opioid sparing effects. Patients in group I were more haemodynamically stable, intraoperatively. Pulmonary function, estimated by peak expiratory flow rate, decreased about 50% postoperatively in both groups. Minimal side effects occurred. In conclusion, a single bolus pre-emptive thoracic PVB with 20 ml ropivacaine 0.5% provides an opioid sparing effect postoperatively, and attenuates the stress response to surgery during isoflurane anaesthesia, a technique which deserves a more widespread

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تاریخ انتشار 2010