Paravertebral Block With Ropivacaine 0.5% Versus Systemic Analgesia for Pain Relief After Thoracotomy
| Autor: | Emmanuel Marret, Jean-Xavier Mazoit, Arnaud Deleuze, Francis Bonnet, Bernard Bazelly, Nadège Lembert, Guillaume Taylor |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Thorax medicine.medical_specialty Visual analogue scale medicine.medical_treatment Analgesic Pain medicine Humans Ropivacaine Paravertebral Block Prospective Studies Thoracotomy Anesthetics Local Infusions Intravenous Acetaminophen Aged Pain Measurement Morphine business.industry Anti-Inflammatory Agents Non-Steroidal Analgesia Patient-Controlled Middle Aged Amides Surgery Analgesics Opioid Ketoprofen Cardiothoracic surgery Anesthesia Drug Therapy Combination Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The Annals of Thoracic Surgery. 79:2109-2113 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2004.07.030 |
| Popis: | Paravertebral block in combination to intravenous analgesics could be an alternative to epidural analgesia for postoperative pain control after thoracotomy, but it has been scarcely evaluated so far. We thus assessed the efficacy of paravertebral block using a continuous infusion of ropivacaine in a multimodal analgesic approach.Forty patients were randomized to receive ketoprofen, paracetamol, and patient-controlled-analgesia (PCA) with intravenous morphine (control group) or the same treatment with a continuous 48-hour infusion of ropivacaine 0.5% (0.1 mL/kg(-1)/h(-1)) in a thoracic paravertebral catheter (thoracic paravertebral block [TPVB] group). Visual analog scale (VAS) at rest and when coughing, morphine consumption, and side effects were recorded during the first 48 hours after surgery. Venous blood was sampled at 24 and 48 hours for ropivacaine plasma concentration measurements.Mean VAS scores at rest and when coughing were significantly decreased in the TPBV group (p0.005). Despite a decrease in the morphine-titrated dose given in the postanesthesia care unit, cumulated morphine consumption was not significantly different between the two groups (51 +/- 29 mg and 57 +/- 24 mg in the TPVB and control groups, respectively). Side effects (nausea, vomiting, urinary retention) were less frequent in the TPBV group (30% vs 75%; p0.005). Plasma ropivacaine concentrations remained below the toxic threshold.Continuous paravertebral ropivacaine 0.5% infusion improves pain control after thoracic surgery using a multimodal analgesic approach. |
| Databáze: | OpenAIRE |
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