scholarly journals Regional Analgesia for Video-Assisted Thoracoscopic Surgery：Thoracic Paravertebral Block Is Recommended As the Optimal Technique

2021 ◽  
Vol 41 (4) ◽  
pp. 367-375
Author(s):  
Chihiro KAMAGATA ◽  
Tadashi OKABE
Keyword(s):  
Paravertebral Block ◽  
Regional Analgesia ◽  
Video Assisted ◽  
Optimal Technique

scholarly journals Effects of Thoracic Paravertebral Block on Nociceptive Levels After Skin Incision During Video-Assisted Thoracoscopic Surgery

2019 ◽  
Vol 25 ◽  
pp. 3140-3145 ◽  
Author(s):  
Hiroki Miyawaki ◽  
Hiroki Ogata ◽  
Shiroh Nakamoto ◽  
Takahiko Kaneko ◽  
Ryusuke Ueki ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Skin Incision ◽  
Paravertebral Block ◽  
Thoracic Paravertebral Block ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Regional versus systemic analgesia in video-assisted thoracoscopic lobectomy: a retrospective analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Benedikt Haager ◽  
Daniel Schmid ◽  
Joerg Eschbach ◽  
Bernward Passlick ◽  
Torsten Loop
Keyword(s):  
Retrospective Analysis ◽  
Regional Anesthesia ◽  
Postoperative Nausea And Vomiting ◽  
Pulmonary Complications ◽  
University Hospital ◽  
Regional Analgesia ◽  
Vats Lobectomy ◽  
Video Assisted ◽  
Hemodynamic Variables ◽  
Secondary Endpoints

Abstract Background The optimal perioperative analgesic strategy in video-assisted thoracic surgery (VATS) for anatomic lung resections remains an open issue. Regional analgesic concepts as thoracic paravertebral or epidural analgesia were used as systemic opioid application. We hypothesized that regional anesthesia would provide improved analgesia compared to systemic analgesia with parenteral opioids in VATS lobectomy and would be associated with a lower incidence of pulmonary complications. Methods The study was approved by the local ethics committee (AZ 99/15) and registered (germanctr.de; DRKS00007529, 10th June 2015). A retrospective analysis of anesthetic and surgical records between July 2014 und February 2016 in a single university hospital with 103 who underwent VATS lobectomy. Comparison of regional anesthesia (i.e. thoracic paravertebral blockade (group TPVB) or thoracic epidural anesthesia (group TEA)) with a systemic opioid application (i.e. patient controlled analgesia (group PCA)). The primary endpoint was the postoperative pain level measured by Visual Analog Scale (VAS) at rest and during coughing during 120 h. Secondary endpoints were postoperative pulmonary complications (i.e. atelectasis, pneumonia), hemodynamic variables and postoperative nausea and vomiting (PONV). Results Mean VAS values in rest or during coughing were measured below 3.5 in all groups showing effective analgesic therapy throughout the observation period. The VAS values at rest were comparable between all groups, VAS level during coughing in patients with PCA was higher but comparable except after 8–16 h postoperatively (PCA vs. TEA; p < 0.004). There were no significant differences on secondary endpoints. Intraoperative Sufentanil consumption was significantly higher for patients without regional anesthesia (p < 0.0001 vs. TPVB and vs. TEA). The morphine equivalence postoperatively applicated until POD 5 was comparable in all groups (mean ± SD in mg: 32 ± 29 (TPVB), 30 ± 27 (TEA), 36 ± 30 (PCA); p = 0.6046). Conclusions Analgesia with TEA, TPVB and PCA provided a comparable and effective pain relief after VATS anatomic resection without side effects. Our results indicate that PCA for VATS lobectomy may be a sufficient alternative compared to regional analgesia. Trial registration The study was registered (germanctr.de; DRKS00007529; 10th June, 2015).

scholarly journals Thoracic Paravertebral Block with Adjuvant Dexmedetomidine in Video-Assisted Thoracoscopic Surgery: A Randomized, Double-Blind Study

2019 ◽  
Vol 8 (3) ◽  
pp. 352 ◽  
Author(s):  
Boohwi Hong ◽  
ChaeSeong Lim ◽  
Hyemin Kang ◽  
Hongsik Eom ◽  
Yeojung Kim ◽  
...  
Keyword(s):  
Rating Scale ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Paravertebral Block ◽  
P Value ◽  
Double Blind Study ◽  
Thoracic Paravertebral Block ◽  
Video Assisted ◽  
Fentanyl Consumption ◽  
Video Assisted Thoracoscopic Surgery

Background: The addition of the adjuvant dexmedetomidine to a nerve block improves the quality of the block and reduces perioperative opioid consumption. The aim of this study was to assess the effect of dexmedetomidine as an adjuvant for the thoracic paravertebral block (TPVB) in postoperative pain control after video-assisted thoracoscopic surgery (VATS). Methods: Sixty-six males, aged 15–40 years, with spontaneous pneumothorax scheduled for VATS wedge resection were enrolled. Following surgery, ultrasound-guided TPVB was performed on the T3 and T5 levels with 30 mL of 0.5% ropivacaine, plus adjuvant dexmedetomidine 50 μg or normal saline. The primary outcome was cumulative fentanyl consumption at 24 h. Pain severity, the requirement for additional rescue analgesics, hemodynamic variations, and side effects were also evaluated. Results: Median postoperative cumulative fentanyl consumption at 24 h was significantly lower in the dexmedetomidine group (122.6 (interquartile range (IQR) 94.5–268.0) μg vs. 348.1 (IQR, 192.8–459.2) μg, p-value = 0.001) with a Hodges–Lehman median difference between groups of 86.2 (95% confidence interval (CI), 4.2–156.4) mg. Coughing numeric rating scale (NRS) was lower in the dexmedetomidine group at postoperative 2, 4, 8, and 24 h. However, resting NRS differed significantly only after 4 h postoperative. Conclusions: Dexmedetomidine as an adjunct in TPVB provided effective pain relief and significantly reduced opioid requirement in VATS.

scholarly journals Low dose intraoperative ketamine infusion with multilevel paravertebral block for pain after video-assisted thoracic surgery: a randomized-controlled study

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Sirilak Suksompong ◽  
Nophanan Chaikittisilpa ◽  
Suthatip Wanchiange ◽  
Suppachai Poolsuppasit ◽  
Punnarerk Thongcharoen ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Low Dose ◽  
Paravertebral Block ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Ketamine Infusion ◽  
Video Assisted Thoracic Surgery ◽  
Randomized Controlled ◽  
Video Assisted
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