Analgesic Efficacy of Thoracoscopic Direct-View Versus Ultrasound-Guided Thoracic Paravertebral Block in Multi-Port Video-Assisted Thoracoscopic Lung Surgery: A Randomized Controlled Non-Inferiority Study
Drug Design Development and Therapy,
Год журнала:
2025,
Номер
Volume 19, С. 1825 - 1838
Опубликована: Март 1, 2025
Purpose:
This
study
compares
the
analgesic
effects
of
Thoracoscopic
Direct-view
Thoracic
Paravertebral
Nerve
Block
(DTPVB)
with
those
Ultrasound-guided
(UTPVB),
providing
a
clinical
reference.
Patients
and
Methods:
Sixty-eight
patients
undergoing
three-port
video-assisted
thoracic
surgery
(VATS)
general
anesthesia
were
randomly
assigned
to
either
DTPVB
group
(Group
D,
n
=
34)
or
UTPVB
U,
34).
Both
groups
received
10
mL
injection
0.75%
ropivacaine
at
T4
T7
interspaces.
Primary
outcomes
cumulative
sufentanil
equivalents
from
start
lung
manipulation
24
hours
postoperatively,
differences
assessed
against
non-inferiority
margin
5
μg
(Δ).
Secondary
include
postoperative
pain
scores,
consumption,
patient
satisfaction,
adverse
effects,
other
related
indicators.
Results:
The
use
postoperatively
was
35.0
±
6.1
in
Group
D
33.2
5.6
no
significant
difference
(P
0.217).
minus
U)
1.8
(95%
CI
−
1.07,
4.65),
within
Postoperative
complications
similar
between
groups.
However,
associated
lower
anxiety
higher
satisfaction
(P<
0.001).
At
15
minutes
post-block,
plasma
concentrations
(P=0.024).
Conclusion:
DTPVB,
via
transmural
pleural
puncture,
non-inferior
efficacy
beginning
lungs
operation
24h
postoperatively.
provides
good
alternative,
especially
for
who
are
anxious
before
surgery,
have
difficulty
cooperating
UTPVB,
cases
where
puncture
fails.
when
using
high
ropivacaine,
greater
vigilance
toxicity
is
required.
Keywords:
paravertebral
block,
TPVB,
thoracoscopic
VATS,
management
Язык: Английский
Serratus anterior plane block alone, paravertebral block alone and their combination in video-assisted thoracoscopic surgery: the THORACOSOPIC double-blind, randomized trial
European Journal of Cardio-Thoracic Surgery,
Год журнала:
2024,
Номер
65(4)
Опубликована: Март 28, 2024
Abstract
OBJECTIVES
Serratus
anterior
plane
block
(SAPB)
and
paravertebral
(PVB)
are
well
known
to
reduce
pain
levels
after
video-assisted
thoracoscopic
surgery
(VATS).
However,
the
relative
efficacies
of
each
a
combination
2
have
not
been
fully
characterized.
The
objective
present
study
was
assess
efficacy
PVB
alone,
SAPB
alone
with
regard
occurrence
intensity
VATS.
METHODS
We
conducted
THORACOSOPIC
single-centre,
double-blind,
randomized
trial
in
adult
patients
due
undergo
elective
VATS
lung
resection.
participants
were
only,
only
+
groups.
primary
end-point
on
coughing
admission
postanaesthesia
care
unit.
secondary
end-points
postoperative
at
rest
other
time
points
cumulative
opioid
consumption.
Pain
scored
visual
analogue
scale.
RESULTS
One-hundred
fifty-six
(52
group)
included.
On
unit,
3
groups
did
differ
significantly
coughing:
scale
score
(0–6),
4
(0–8)
(0–6)
PVB,
groups,
respectively
(P
=
0.204).
During
care,
overall
lower
SABP
PVP
group
cough.
CONCLUSIONS
could
be
beneficial
for
management
comparison
or
alone.
Язык: Английский
Loco-Regional Anesthesia for Pain Management in Robotic Thoracic Surgery
Journal of Clinical Medicine,
Год журнала:
2024,
Номер
13(11), С. 3141 - 3141
Опубликована: Май 27, 2024
Robotic
thoracic
surgery
is
a
prominent
minimally
invasive
approach
for
the
treatment
of
various
diseases.
While
this
technique
offers
numerous
benefits
including
reduced
blood
loss,
shorter
hospital
stays,
and
less
postoperative
pain,
effective
pain
management
remains
crucial
to
enhance
recovery
minimize
complications.
This
review
focuses
on
application
loco-regional
anesthesia
techniques
in
robotic
surgery,
particularly
emphasizing
their
role
management.
Techniques
such
as
local
infiltration
(LIA),
epidural
(TEA),
paravertebral
block
(PVB),
intercostal
nerve
(INB),
erector
spinae
plane
(ESPB)
are
explored
detail
regarding
methodologies,
benefits,
potential
limitations.
The
also
discusses
imperative
integrating
these
methods
with
optimize
patient
outcomes.
findings
suggest
that
while
each
has
unique
advantages,
choice
should
be
tailored
patient’s
clinical
status,
complexity
specific
requirements
procedures.
concludes
multimodal
analgesia
strategy,
potentially
incorporating
several
techniques,
may
offer
most
managing
perioperative
surgery.
Future
directions
include
refining
through
technological
advancements
like
ultrasound
guidance
exploring
long-term
impacts
surgical
outcomes
context
Язык: Английский
Is paravertebral block the new standard of care for postoperative analgesia after thoracoscopic surgery?
Journal of Thoracic Disease,
Год журнала:
2024,
Номер
16(4), С. 2677 - 2680
Опубликована: Апрель 1, 2024
Язык: Английский
Thoracic wall block for minimally invasive thoracic surgery: enough analgesic advantages to improve functional outcomes?
Minerva Anestesiologica,
Год журнала:
2024,
Номер
90(6)
Опубликована: Июнь 1, 2024
Язык: Английский
Effect of Surgeon-Performed Thoracic Paravertebral Block on Postoperative Pain in Adolescent Idiopathic Scoliosis Surgery: A Prospective Randomized Controlled Trial
Journal of Personalized Medicine,
Год журнала:
2024,
Номер
14(6), С. 659 - 659
Опубликована: Июнь 20, 2024
Posterior
spinal
fusion
for
adolescent
idiopathic
scoliosis
(AIS)
causes
severe
postoperative
pain.
Thoracic
paravertebral
block
(PVB)
provides
excellent
analgesia
during
various
surgeries.
We
examined
the
effects
of
PVB
on
in
children
undergoing
AIS
surgery.
In
this
study,
32
scheduled
surgery
were
randomly
assigned
to
receive
either
(PVB
group)
or
no
(control
group).
The
group
underwent
surgeon-performed
with
0.5
mL/kg
adrenalized
0.2%
ropivacaine
each
side.
primary
outcome
was
pain
score
at
rest
6
h
postoperatively.
Secondary
outcomes
included
scores
both
and
movement
analgesic
use
48
resting
comparable
between
control
groups
(5.2
±
2.0
5.1
1.8,
respectively),
significant
differences.
However,
1
postoperatively,
showed
significantly
higher
mean
moving
than
(p
<
0.05).
other
time
points
groups.
Initial
benefits
bilateral
observed
but
diminished
Future
research
using
anesthetics
is
needed
extend
PVB.
Язык: Английский
The Delineation of Another Standard for Postoperative Pain Management Following Thoracic Surgery
JAMA Surgery,
Год журнала:
2023,
Номер
158(12), С. 1263 - 1263
Опубликована: Окт. 25, 2023
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