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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...

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Autores principales: Patel, Anuradha, Kumar, Vinod, Garg, Rakesh, Bhatnagar, Sushma, Mishra, Seema, Gupta, Nishkarsh, Bharti, Sachidanand Jee, Kumar, Sunil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
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.
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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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