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Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-A prospective randomized study
CONTEXT: Inadequate pain relief after thoracotomy may lead to postoperative respiratory complications. AIMS: We have compared total morphine consumption in 24 hours following thoracotomy. SETTINGS AND DESIGN: This prospective randomized pilot study involved 50 patients undergoing elective thoracotom...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796745/ https://www.ncbi.nlm.nih.gov/pubmed/33447181 http://dx.doi.org/10.4103/sja.SJA_143_20 |
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author | Patel, Anuradha Kumar, Vinod Garg, Rakesh Bhatnagar, Sushma Mishra, Seema Gupta, Nishkarsh Bharti, Sachidanand Jee Kumar, Sunil |
author_facet | Patel, Anuradha Kumar, Vinod Garg, Rakesh Bhatnagar, Sushma Mishra, Seema Gupta, Nishkarsh Bharti, Sachidanand Jee Kumar, Sunil |
author_sort | Patel, Anuradha |
collection | PubMed |
description | CONTEXT: Inadequate pain relief after thoracotomy may lead to postoperative respiratory complications. AIMS: We have compared total morphine consumption in 24 hours following thoracotomy. SETTINGS AND DESIGN: This prospective randomized pilot study involved 50 patients undergoing elective thoracotomy for lung surgery at AIIMS, New Delhi. PATIENTS AND METHODS: Fifty patients undergoing elective thoracotomy were randomly allocated into two groups. In Group I patients, ultrasound (USG)-guided paravertebral catheter was inserted preoperatively and in Group II patients, serratus anterior plane (SAP) catheter was inserted by the surgeon before closure. Ropivacaine bolus (group I: 0.2% 0.1 ml/kg and group II: 0.375% 0.4 ml/kg) was given before extubation, followed by its continuous infusion for 24 hours. If the numerical rating scale (NRS) was >3, then patients were given intravenous (i.v.) morphine 3 mg. Total 24-hour morphine consumption, duration of effective analgesia, hemodynamic parameters, side effects, and overall patient satisfaction were recorded. STATISTICAL ANALYSIS USED: T-test was used to compare the parametric values in both the groups, whereas the Mann–Whitney U-test was performed to compare the nonparametric values. RESULTS: Postoperative morphine requirement in the ParaVertebral Block (PVB) group (8.65 ± 4.27 mg) was less as compared to the SAP group (11.87 ± 6.22 mg) but that was not statistically significant (p 0.052). Postoperative pain scores at rest and on movement, patient satisfaction, and incidence of chronic post-thoracotomy pain were comparable in both the groups. CONCLUSION: SAP block with continuous catheter technique seems to be a safe and effective modality for the management of acute postoperative pain after thoracotomy. |
format | Online Article Text |
id | pubmed-7796745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-77967452021-01-13 Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-A prospective randomized study Patel, Anuradha Kumar, Vinod Garg, Rakesh Bhatnagar, Sushma Mishra, Seema Gupta, Nishkarsh Bharti, Sachidanand Jee Kumar, Sunil Saudi J Anaesth Original Article CONTEXT: Inadequate pain relief after thoracotomy may lead to postoperative respiratory complications. AIMS: We have compared total morphine consumption in 24 hours following thoracotomy. SETTINGS AND DESIGN: This prospective randomized pilot study involved 50 patients undergoing elective thoracotomy for lung surgery at AIIMS, New Delhi. PATIENTS AND METHODS: Fifty patients undergoing elective thoracotomy were randomly allocated into two groups. In Group I patients, ultrasound (USG)-guided paravertebral catheter was inserted preoperatively and in Group II patients, serratus anterior plane (SAP) catheter was inserted by the surgeon before closure. Ropivacaine bolus (group I: 0.2% 0.1 ml/kg and group II: 0.375% 0.4 ml/kg) was given before extubation, followed by its continuous infusion for 24 hours. If the numerical rating scale (NRS) was >3, then patients were given intravenous (i.v.) morphine 3 mg. Total 24-hour morphine consumption, duration of effective analgesia, hemodynamic parameters, side effects, and overall patient satisfaction were recorded. STATISTICAL ANALYSIS USED: T-test was used to compare the parametric values in both the groups, whereas the Mann–Whitney U-test was performed to compare the nonparametric values. RESULTS: Postoperative morphine requirement in the ParaVertebral Block (PVB) group (8.65 ± 4.27 mg) was less as compared to the SAP group (11.87 ± 6.22 mg) but that was not statistically significant (p 0.052). Postoperative pain scores at rest and on movement, patient satisfaction, and incidence of chronic post-thoracotomy pain were comparable in both the groups. CONCLUSION: SAP block with continuous catheter technique seems to be a safe and effective modality for the management of acute postoperative pain after thoracotomy. Wolters Kluwer - Medknow 2020 2020-09-24 /pmc/articles/PMC7796745/ /pubmed/33447181 http://dx.doi.org/10.4103/sja.SJA_143_20 Text en Copyright: © 2020 Saudi Journal of Anesthesia http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Patel, Anuradha Kumar, Vinod Garg, Rakesh Bhatnagar, Sushma Mishra, Seema Gupta, Nishkarsh Bharti, Sachidanand Jee Kumar, Sunil Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-A prospective randomized study |
title | Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-A prospective randomized study |
title_full | Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-A prospective randomized study |
title_fullStr | Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-A prospective randomized study |
title_full_unstemmed | Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-A prospective randomized study |
title_short | Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-A prospective randomized study |
title_sort | comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy for lung surgery-a prospective randomized study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796745/ https://www.ncbi.nlm.nih.gov/pubmed/33447181 http://dx.doi.org/10.4103/sja.SJA_143_20 |
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