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J Cardiothorac Vasc Anesth. 2014 Aug;28(4):966-72. doi: 10.1053/j.jvca.2013.12.007. Epub 2014 Mar 29.

Single-dose, bilateral paravertebral block plus intravenous sufentanil analgesia in patients with esophageal cancer undergoing combined thoracoscopic-laparoscopic esophagectomy: a safe and effective alternative.

Author information

1
Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
2
Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China. Electronic address: doctor_fc@163.com.

Abstract

OBJECTIVE:

Paravertebral block (PVB) has been shown to be an ideal aid for analgesia after thoracic or abdominal surgery. The authors studied the safety and efficacy of the single-dose and bilateral ultrasound-guided (USG)-PVB before combined thoracoscopic-laparoscopic esophagectomy (TLE) along with intravenous sufentanil analgesia as a method of pain relief in comparison with intravenous sufentanil as a sole analgesic agent.

DESIGN:

Prospective, randomized study.

SETTING:

Single university hospital.

PARTICIPANTS:

Fifty-two patients undergoing TLE.

INTERVENTIONS:

A USG-PVB was performed before surgery using a solution of 30 mL of 0.5% ropivacaine by 3 injections of 10 mL each at the right T5 and bilateral T8 (PVB group, n=26) or the saline injection of 10 mL at every site (control group, n=26).

MEASUREMENTS AND MAIN RESULTS:

Successful PVBs were achieved in all patients of the PVB group. Intraoperative mean remifentanil usage and end-tidal sevoflurane concentration were lower in the PVB group (p<0.001). Hemodynamic parameters were stable in both groups. Postoperative pain scores both at rest and on coughing were lower during the first 8 hours in the PVB group than those in the control group (p<0.05). Cumulative sufentanil consumption delivered by patient-controlled analgesia (PCA) was significantly lower in the PVB group at all time points (p<0.05). Postoperative pulmonary function was better at the third postoperative day in the PVB group (p<0.05), with quicker hospital discharge and lower hospital costs (p<0.05).

CONCLUSIONS:

The single-dose and bilateral PVB given before TLE combined with sufentanil may provide better postoperative analgesia and early discharge in patients undergoing TLE.

KEYWORDS:

analgesia; combined thoracoscopic-laparoscopic esophagectomy; paravertebral block; postoperative pain

PMID:
24686029
DOI:
10.1053/j.jvca.2013.12.007
[Indexed for MEDLINE]
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