Single Dose Preemptive Thoracic Paravertebral Block For Postoperative Pain Relief After Cholecystectomy
نویسندگان
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
منابع مشابه
Efficacy of single-injection unilateral thoracic paravertebral block for post open cholecystectomy pain relief: a prospective randomized study at Gondar University Hospital
BACKGROUND Cholecystectomy can be associated with considerable postoperative pain. While the benefits of paravertebral block (PVB) on pain after thoracotomy and mastectomy have been demonstrated, not enough investigations on the effects of PVB on pain after open cholecystectomy have been conducted. We tested the hypothesis that a single-injection thoracic PVB reduces pain scores, decreases opio...
متن کامل[Clinical application of thoracic paravertebral anesthetic block in breast surgeries].
INTRODUCTION optimum treatment for postoperative pain has been of fundamental importance in surgical patient care. Among the analgesic techniques aimed at this group of patients, thoracic paravertebral block combined with general anesthesia stands out for the good results and favorable risk-benefit ratio. Many local anesthetics and other adjuvant drugs are being investigated for use in this tec...
متن کاملEvaluation of the role of dexmedetomidine in improvement of the analgesic profile of thoracic paravertebral block in thoracic surgeries: A randomised prospective clinical trial
Background and Aims Thoracic paravertebral block (TPB) is one of the effective methods for management of post-operative pain in thoracic surgeries. The aim of the study was to evaluate effectiveness of addition of dexmedetomidine to paravertebral block with bupivacaine in improving the postoperative pain relief and pulmonary functions in patients undergoing thoracic surgeries. Methods A prosp...
متن کاملComparative Evaluation of Continuous Thoracic Paravertebral Block and Thoracic Epidural Analgesia Techniques for Post-operative Pain Relief in Patients Undergoing Open Nephrectomy: A Prospective, Randomized, Single-blind Study
BACKGROUND Open surgical procedures are associated with substantial postoperative pain; an alternative method providing adequate pain relief with minimal side effects is very much required. AIM The aim of this study was a comparative evaluation of the efficacy of continuous thoracic paravertebral block (PVB) and thoracic epidural analgesia (EA) for postoperative pain relief in patients underg...
متن کاملThoracic paravertebral block after thoracotomy: comparison of three different approaches.
BACKGROUND Thoracic paravertebral block (TPVB) is a regional block technique increasingly used for the early management of post-thoracotomy pain. We compare three different postoperative analgesic approaches based on TPVB: anesthetist, anesthetist plus surgeon, and surgeon. MATERIALS AND METHODS We randomized 54 patients undergoing elective thoracotomy to three different postoperative analges...
متن کامل