The effects of preoperative single-dose thoracic paravertebral block on acute and chronic pain after thoracotomy: A randomized, controlled, double-blind trial

• Published in: Medicine (Baltimore) 2018-06, Vol.97 (24), p.e11181-e11181
• Main Authors: Li, Xiu-Liang, Zhang, Ye, Dai, Tian, Wan, Lei, Ding, Guan-Nan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthetics, Intravenous - administration & dosage; Anesthetics, Intravenous - adverse effects; Clinical Trial/Experimental Study; Double-Blind Method; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nerve Block - adverse effects; Nerve Block - methods; Pain Measurement; Pain, Postoperative - drug therapy; Preoperative Care - methods; Sufentanil - administration & dosage; Sufentanil - adverse effects; Thoracotomy - adverse effects; Treatment Outcome
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000011181

Patients undergoing thoracotomy frequently experience acute pain and chronic post-thoracotomy pain (CPTP). There are few articles relating to the investigations on the effects of preoperative single-dose thoracic paravertebral block (PSTPVB) on acute pain and CPTP. We tested the hypothesis that adding PSTPVB to intravenous (IV) patient-controlled analgesia (PCA) would reduce acute pain scores and decrease the incidence and intensity of CPTP. Fifty-six patients undergoing elective thoracotomy were randomized to receive PSTPVB in addition to IV PCA (group T) or IV PCA alone (group C). A single 20-mL injection of 0.50% ropivacaine plus 10 mg dexamethasone in saline was administered preoperatively under ultrasound guidance; sufentanil was used for IV PCA. The acute pain intensity at rest and at coughing based on verbal rating scale, postoperative sufentanil consumption, and complications were evaluated at 6, 24, 48, and 72 hours after surgery. The incidence and intensity of CPTP were evaluated at 3 months after surgery. Group T had significantly less acute pain compared with group C at all measurement times both at rest and at coughing (P  .05). The intensity of CPTP was significantly higher in group C than in group T (P