Journal de la douleur et du soulagement

Abstrait

Is Paravertebral Block More Effective in Thoracotomy Patients Compared to Thoracic Epidural Block?

Mohamed Ali Bakry* and Hisham Mohamed Mohamed Salem

Purpose: Paravertebral block (PVB) is a simple and safe technique that can be more efficacious than epidural block (EPB) in controlling postoperative pain. We aimed to confirm this by comparing the two methods in patients after thoracotomy.

Methods: Patients were randomly divided into two groups, PVB or EPB (n=30 in each). Vital signs and the visual analog scale (VAS) were evaluated before giving the block then 30 minutes and 3, 6, 9 and 12 hours after thoracotomy. Complications and need for additional analgesic agents were also scrutinized.

Results: The most significant finding was better preservation of pulmonary function tests at most time points in the PVB group (<0.05). VAS scores trended to be better in the PVB group, but the difference was significant only at 30 minutes after giving the block. There were no significant differences between the groups in the incidence of complications or the need for additional analgesic agents.

Conclusion: Paravertebral and epidural blocks are effective in a similar degree in controlling post-operative pain but paravertebral block is safer and more tolerable for the patients.