Skip Navigation



BJA Advance Access published online on September 30, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei250
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
95/6/816    most recent
aei250v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Vogt, A.
Right arrow Articles by Curatolo, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Vogt, A.
Right arrow Articles by Curatolo, M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted June 28, 2005

Clinical Investigation

Single-injection thoracic paravertebral block for postoperative pain treatment after thoracoscopic surgery{dagger}

A. Vogt 1*, D. S. Stieger 2, C. Theurillat 3, and M. Curatolo 3

1 Department of Anaesthesiology, Division of Thoracic Surgery, University Hospital of Bern, Inselspital, 3010 Bern, Switzerland
2 Department of Anaesthesiology, Lindenhofspital, Bremgartenstrasse 117, 3012 Bern, Switzerland
3 Department of Anaesthesiology, Division of Pain Therapy, University Hospital of Bern, Inselspital, 3010 Bern, Switzerland

* To whom correspondence should be addressed.
A. Vogt, E-mail: andreas.vogt{at}insel.ch


  Abstract

Background. Thoracoscopic surgery can be associated with considerable postoperative pain. While the benefits of paravertebral block on pain after thoracotomy have been demonstrated, no investigations on the effects of paravertebral block on pain after thoracoscopy have been conducted. We tested the hypothesis that a single-injection thoracic paravertebral block, performed preoperatively, reduces pain scores after thoracoscopic surgery.

Methods. Of 45 patients recruited, 40 completed the study. They were randomly allocated to two groups: the paravertebral group received i.v. patient-controlled analgesia (PCA) with morphine plus single-injection thoracic paravertebral block with bupivacaine 0.375% and adrenaline 1:200 000 0.4 ml kg-1 (n=20). The control group was treated with a back puncture without injection and morphine PCA (n=20).

Results. The main outcomes recorded during 48 h after surgery were pain scores using the visual analogue scale (VAS, 0-100). Secondary outcomes were cumulative morphine consumption and peak expiratory flow rate (PEFR). Half an hour and 24 h after surgery, median (25th-75th percentiles) VAS on coughing in the paravertebral group was 31.0 (20.0-55.0) and 30.5 (17.5-40.0) respectively and in the control group it was 70.0 (30.0-100.0) and 50.0 (25.0-75.0) respectively. The difference between the groups over the whole observation period was statistically significant (P<0.05). Twenty-four and 48 h after surgery, median (25th-75th percentiles) cumulative morphine consumption (mg) was 49.0 (38.3-87.0) and 69.3 (38.8-118.5) respectively in the paravertebral group and 51.2 (36.0-84.1) and 78.1 (38.4-93.1) in the control group (statistically not significant). No differences were found in PEFR or the incidence of any side-effects between groups.

Conclusion. We conclude that single-shot preoperative paravertebral block improves post-operative pain treatment after thoracoscopic surgery in a clinically significant fashion.

Keywords: anaesthesia, regional; thoracic paravertebral block; pain, postoperative; pain, treatment; surgery, thoracoscopic.
{dagger}This article is accompanied by the Editorial.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Br J AnaesthHome page
C. Luyet, U. Eichenberger, R. Greif, A. Vogt, Z. Szucs Farkas, and B. Moriggl
Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study
Br. J. Anaesth., April 1, 2009; 102(4): 534 - 539.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
J. Richardson and S. Cheema
Thoracic paravertebral nerve block.
Br. J. Anaesth., April 1, 2006; 96(4): 537 - 537.
[Full Text] [PDF]

Home page
 Br J AnaesthHome page
P.-A. Lonnqvist
Pre-emptive analgesia with thoracic paravertebral blockade?
Br. J. Anaesth., December 1, 2005; 95(6): 727 - 728.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.