scholarly journals Effect of Combined Thoracic Paravertebral Block and General Anesthesia vs General Anesthesia Alone on Postoperative Stress and Pain in Patients Undergoing Laparoscopic Radical Nephrectomy

2021 ◽  
Vol 27 ◽  
Author(s):  
Tao Tang ◽  
Fengjiao Lang ◽  
Shoulin Gao ◽  
Li Chen
Keyword(s):  
General Anesthesia ◽  
Radical Nephrectomy ◽  
Paravertebral Block ◽  
Thoracic Paravertebral Block ◽  
Laparoscopic Radical Nephrectomy ◽  
Postoperative Stress

The Resolution of ST Segment Depressions After High Right Thoracic Paravertebral Block During General Anesthesia

2002 ◽  
Vol 95 (1) ◽  
pp. 227-228 ◽  
Author(s):  
Anthony M.-H. Ho ◽  
Huey S. Lim ◽  
Anthony P.C. Yim ◽  
Manoj K. Karmakar ◽  
Tak Wai Lee
Keyword(s):  
General Anesthesia ◽  
Paravertebral Block ◽  
Thoracic Paravertebral Block ◽  
St Segment

scholarly journals Serum IL-6 Level in Breast Cancer Surgery: Evaluating the Addition of Hydrocortisone to Two Anesthetic Regimens

2015 ◽  
Vol 9 (1) ◽  
pp. 29-35
Author(s):  
Sherif Abdelhamid ◽  
Ahmed Talha ◽  
Salwa Hamdy ◽  
Ashraf Arafat Abdelhalim ◽  
Mohamed Elakany
Keyword(s):  
Breast Cancer ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Cancer Surgery ◽  
Paravertebral Block ◽  
Breast Cancer Surgery ◽  
Serum Cortisol Level ◽  
Control Group ◽  
Thoracic Paravertebral Block

Background: This study was purposed to compare in vitro the volumetric accuracy of a newly introduced automatic infusion controller, AutoClamp with that of other commonly used infusion devices. Methods: In this prospective, randomized, controlled trial, 124 ASA I-II, female patients, aged 30-50 years, undergoing conservative breast cancer surgery were randomly assigned to one of four equal groups receiving either standard general anesthesia and two doses of hydrocortisone (Group GH, n=31), thoracic paravertebral block and two doses of hydrocortisone (Group PH, n=31), standard general anesthesia with no hydrocortisone (Group G, n=31), or thoracic paravertebral block with no hydrocortisone (Group P, n=31). IL-6 was measured at three time points: before operation, 6 and 12 hours postoperatively. CRP and cortisol were measured preoperatively and 6 hours postoperatively. Results: On comparing group PH and GH, there was significant decrease in IL-6 level in group PH compared to group GH at 6 hour (122.1±21.2 vs 135.8±29.8pg/dl), but insignificant difference at 24 hours (107.9±21.6 vs 106.8±15.9pg/dl). CRP showed significant decrease in the postoperative reading in group PH compared to group GH (1.63±0.32 vs 1.91±0.43mg/l), and also group PH showed significant decrease compared to the control group P (1.63±0.32 vs 2.2±0.54). Conclusion: addition of hydrocortisone to general anesthesia or thoracic paravertebral block attenuated production of IL-6 and CRP levels significantly postoperatively compared to either anesthetic regimen alone, but not the serum cortisol level, highlighting its role in modifying the stress response to surgery. However, the effect was more pronounced when combined with thoracic paravertebral block.

scholarly journals Effect of general anesthesia with thoracic paravertebral block on postoperative delirium in elderly patients undergoing thoracoscopic lobectomy: a randomized-controlled trial

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Wei Wei ◽  
Xi Zheng ◽  
Yu Gu ◽  
Wenting Fu ◽  
Chunlin Tang ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Elderly Patients ◽  
General Anesthesia ◽  
Postoperative Delirium ◽  
Paravertebral Block ◽  
Enzyme Linked Immunosorbent Assay ◽  
Thoracic Paravertebral Block ◽  
Link Type ◽  
Thoracoscopic Lobectomy ◽  
Tnf Α

Abstract Background Postoperative delirium (POD) is characterized by acute brain dysfunction, especially in elderly patients. Postoperative pain is an important factor in the development of delirium, and effective pain management can reduce the risk of POD. Thoracic paravertebral block (TPVB) can effectively relieve postoperative pain and inhibit the perioperative stress and inflammatory response. We investigated whether the combination of TPVB with general anesthesia reduced the occurrence of POD following thoracoscopic lobectomy. Methods A total of 338 elderly patients, aged 65–80 years, who underwent elective surgery for video-assisted thoracoscopic lobectomy (VATS) were randomly assigned to either a patient-controlled intravenous analgesia group (PIA) or a patient-controlled paravertebral-block analgesia group (PBA). POD was evaluated using the 3-min diagnostic confusion assessment method (3D-CAM). The postoperative quality of recovery (QoR) was assessed with Chinese version of QoR-40 scale. Pain intensity was measured using the visual analog scale (VAS) score. Tumor necrosis factor-α (TNF-α) and neurofilament light (NFL) levels were determined using enzyme-linked immunosorbent assay (ELISA) kits. Results Delirium occurred in 47 (28%) of 168 cases in the PIA group and 28 (16.5%) of 170 cases in the PBA group (RR 1.7, p = 0.03). PBA was also associated with a higher rate of overall recovery quality at day 7 after surgery (27.1% vs. 17.3%, P = 0.013) compared with PIA. The incremental change in surgery-induced TNF-α and NFL was greater in the PIA group than PBA group (p < 0.05). Conclusion Thoracic paravertebral block analgesia is associated with lower incidence of postoperative delirium, probably due to its anti-neuroinflammatory effects. Furthermore, as a component of multimodal analgesia, TPVB provides not only superior analgesic but also opioid-sparing effects. Trial registration The study was registered on the Chinese Clinical Trial Registry Center (www.chictr.org.cn; registration number: ChiCTR 2,000,033,238) on 25/05/2018.

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