Cargando…

The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy

BACKGROUND: Paravertebral block is a popular regional anesthetic technique used for perioperative analgesia in multiple surgical procedures. There are very few randomized trials of its use in laparoscopic cholecystectomy in medical literature. This study was aimed at assessing its efficacy and opioi...

Descripción completa

Detalles Bibliográficos
Autores principales: Agarwal, Anil, Batra, Ravinder K., Chhabra, Anjolie, Subramaniam, Rajeshwari, Misra, Mahesh C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591552/
https://www.ncbi.nlm.nih.gov/pubmed/23493523
http://dx.doi.org/10.4103/1658-354X.105860
_version_ 1782262070289367040
author Agarwal, Anil
Batra, Ravinder K.
Chhabra, Anjolie
Subramaniam, Rajeshwari
Misra, Mahesh C.
author_facet Agarwal, Anil
Batra, Ravinder K.
Chhabra, Anjolie
Subramaniam, Rajeshwari
Misra, Mahesh C.
author_sort Agarwal, Anil
collection PubMed
description BACKGROUND: Paravertebral block is a popular regional anesthetic technique used for perioperative analgesia in multiple surgical procedures. There are very few randomized trials of its use in laparoscopic cholecystectomy in medical literature. This study was aimed at assessing its efficacy and opioid-sparing potential in this surgery. METHODS: Fifty patients were included in this prospective randomized study and allocated to two groups: Group A (25 patients) receiving general anesthesia alone and Group B (25 patients) receiving nerve-stimulator–guided bilateral thoracic Paravertebral Block (PVB) at T6 level with 0.3 ml/kg of 0.25% bupivacaine prior to induction of general anesthesia. Intraoperative analgesia was supplemented with fentanyl (0.5 μg/kg) based on hemodynamic and clinical parameters. Postoperatively, patients in both the groups received Patient-Controlled Analgesia (PCA) morphine for the first 24 hours. The efficacy of PVB was assessed by comparing intraoperative fentanyl requirements, postoperative VAS scores at rest, and on coughing and PCA morphine consumption between the two groups. RESULTS: Intraoperative supplemental fentanyl was significantly less in Group B compared to Group A (17.6 μg and 38.6 μg, respectively, P =0.001). PCA morphine requirement was significantly low in the PVB group at 2, 6, 12, and 24 hours postoperatively compared to that in Group A (4.4 mg vs 6.9 mg, 7.6 mg vs 14.2 mg, 11.6 mg vs 20.0 mg, 16.8 mg vs 27.2 mg, respectively; P <0.0001 at all intervals). CONCLUSION: Pre-induction PVB resulted in improved analgesia for 24 hours following laparoscopic cholecystectomy in this study, along with a significant reduction in perioperative opioid consumption and opioid-related side effects.
format Online
Article
Text
id pubmed-3591552
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-35915522013-03-14 The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy Agarwal, Anil Batra, Ravinder K. Chhabra, Anjolie Subramaniam, Rajeshwari Misra, Mahesh C. Saudi J Anaesth Original Article BACKGROUND: Paravertebral block is a popular regional anesthetic technique used for perioperative analgesia in multiple surgical procedures. There are very few randomized trials of its use in laparoscopic cholecystectomy in medical literature. This study was aimed at assessing its efficacy and opioid-sparing potential in this surgery. METHODS: Fifty patients were included in this prospective randomized study and allocated to two groups: Group A (25 patients) receiving general anesthesia alone and Group B (25 patients) receiving nerve-stimulator–guided bilateral thoracic Paravertebral Block (PVB) at T6 level with 0.3 ml/kg of 0.25% bupivacaine prior to induction of general anesthesia. Intraoperative analgesia was supplemented with fentanyl (0.5 μg/kg) based on hemodynamic and clinical parameters. Postoperatively, patients in both the groups received Patient-Controlled Analgesia (PCA) morphine for the first 24 hours. The efficacy of PVB was assessed by comparing intraoperative fentanyl requirements, postoperative VAS scores at rest, and on coughing and PCA morphine consumption between the two groups. RESULTS: Intraoperative supplemental fentanyl was significantly less in Group B compared to Group A (17.6 μg and 38.6 μg, respectively, P =0.001). PCA morphine requirement was significantly low in the PVB group at 2, 6, 12, and 24 hours postoperatively compared to that in Group A (4.4 mg vs 6.9 mg, 7.6 mg vs 14.2 mg, 11.6 mg vs 20.0 mg, 16.8 mg vs 27.2 mg, respectively; P <0.0001 at all intervals). CONCLUSION: Pre-induction PVB resulted in improved analgesia for 24 hours following laparoscopic cholecystectomy in this study, along with a significant reduction in perioperative opioid consumption and opioid-related side effects. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3591552/ /pubmed/23493523 http://dx.doi.org/10.4103/1658-354X.105860 Text en Copyright: © Saudi Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Agarwal, Anil
Batra, Ravinder K.
Chhabra, Anjolie
Subramaniam, Rajeshwari
Misra, Mahesh C.
The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy
title The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy
title_full The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy
title_fullStr The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy
title_full_unstemmed The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy
title_short The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy
title_sort evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591552/
https://www.ncbi.nlm.nih.gov/pubmed/23493523
http://dx.doi.org/10.4103/1658-354X.105860
work_keys_str_mv AT agarwalanil theevaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT batraravinderk theevaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT chhabraanjolie theevaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT subramaniamrajeshwari theevaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT misramaheshc theevaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT agarwalanil evaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT batraravinderk evaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT chhabraanjolie evaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT subramaniamrajeshwari evaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy
AT misramaheshc evaluationofefficacyandsafetyofparavertebralblockforperioperativeanalgesiainpatientsundergoinglaparoscopiccholecystectomy