Can thoracic paravertebral block replace thoracic epidural block in pediatric cardiac surgery? A randomized blinded study
| Autor: | Mohamed-Adel Elgamal, Tariq El-Desouky, Ashraf A. Elsharkawy, Alaa El-Deeb, Gamal Z. El-Morsy |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_treatment Post-thoracotomy pain Pulmonary function testing law.invention lcsh:RD78.3-87.3 Paravertebral block Randomized controlled trial Double-Blind Method law medicine Humans Paravertebral Block Thoracotomy Cardiac Surgical Procedures Pain Postoperative business.industry Infant Nerve Block General Medicine Epidural block Surgery Cardiac surgery Analgesia Epidural Catheter Anesthesiology and Pain Medicine lcsh:Anesthesiology lcsh:RC666-701 Anesthesia Nerve block Vomiting Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Annals of Cardiac Anaesthesia, Vol 15, Iss 4, Pp 259-263 (2012) |
| ISSN: | 0971-9784 |
| Popis: | To compare the outcomes of thoracic epidural block with thoracic paravertebral block for thoracotomy in pediatric patients. A prospective double-blind study. 60 pediatric patients aged 1-24 months, ASA II, III scheduled for thoracotomy were randomly allocated into two groups. After induction of general anesthesia, thoracic epidural catheter was inserted in group E (epidural) patients and thoracic paravertebral catheter was inserted in group P (paravertebral) patients. Post operative pain score was recorded hourly for 24 hours. Plasma cortisol level was recorded at three time points. Tidal breathing analysis was done preoperatively and 6 hours postoperatively. Analgesia, serum cortisol level, and pulmonary function parameters were comparable in the two groups. However, failure rate (incorrect placement of catheter) was significantly higher in epidural group than in paravertebral group (7% versus 0%, respectively). The complications were also significantly higher in epidural group (vomiting 14.8%, urine retention 11.1% and hypotension 14.8%) than paravertebral group (0%, 0%, and 3.6%, respectively). We conclude that both thoracic paravertebral block and thoracic epidural block results in comparable pain score and pulmonary function after thoracotomy in pediatric patients; the paravertebral block is associated with significantly less failure rate and side effects. |
| Databáze: | OpenAIRE |
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