Abstract
Background and objectives
The aim of this study was to investigate the effects of preemptive ultrasound-guided thoracic paravertebral block versus intercostal block on postoperative respiratory function and pain control in patients undergoing video-assisted thoracoscopic surgery.
Subjects
50 consecutive patients undergoing video-assisted thoracoscopic surgery.
Method
A prospective cohort of patients who received either ultrasound-guided thoracic paravertebral block immediately before the procedure or intercostal block placed by the surgeon at the end of the procedure were studied. Pulmonary function was assessed before surgery and 4 h postoperatively. Pain was assessed with the visual analog scale at 2 and 4 h after surgery both at rest and on coughing.
Results
30 patients on the paravertebral block group and 20 on the intercostal block group were studied. Forced vital capacity (p < 0.001), forced expiratory volume at 1 s (p < 0.001) and forced expiratory flow 25–75 % (p = 0.001) were significantly higher at 4 h with paravertebral block compared to the intercostal block group. The visual analog score for pain was significantly improved with paravertebral block at rest (p < 0.05) and with cough (p = 0.00). Perioperative narcotic use was significantly reduced with paravertebral block in comparison to intercostal block (p = 0.04).
Conclusions
When compared to intercostal blocks, ultrasound-guided thoracic paravertebral block appears to preserve lung function and provide better pain control in the immediate postoperative period after video-assisted thoracoscopic surgery.
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Conflict of interest disclosure
Robina Matyal has declared that no conflict of interest exists.
Mario Montealegre-Gallegos has declared that no conflict of interest exists.
Khurram Owais has declared that no conflict of interest exists.
Sruthi Sakamuri has declared that no conflict of interest exists.
Marc Shnider has declared that no conflict of interest exists.
Omair Shakil has declared that no conflict of interest exists.
Vipul Shah has declared that no conflict of interest exists.
Sidharta Gangadharan has declared that no conflict of interest exists.
John Pawlowski has declared that no conflict of interest exists.
Phillip Hess has declared that no conflict of interest exists.
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Matyal, R., Montealegre-Gallegos, M., Shnider, M. et al. Preemptive ultrasound-guided paravertebral block and immediate postoperative lung function. Gen Thorac Cardiovasc Surg 63, 43–48 (2015). https://doi.org/10.1007/s11748-014-0442-6
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DOI: https://doi.org/10.1007/s11748-014-0442-6