The comparison of analgesic efficacy between ultrasound-guided continuous thoracic paravertebral block and continuous thoracic epidural block using bupivacaine - fentanyl in patients undergoing lung surgery: A prospective, randomized, controlled trial
Tran Thanh Trung1, Dang Van Khoa1, Trinh Van Dong2
1Department of Anesthesiology - Resuscitation, 74 Central Hospital, Vinh Phuc, Vietnam
2Department of Anesthesiology - Resuscitation, Viet Duc University Hospital, Hanoi, Vietnam
Objective: This study aimed to compare the efficacy and the safety of ultrasound-guided continuous thoracic paravertebral block (CTPB) to the continuous thoracic epidural block (CTEB) for pain relief in patients undergoing lung surgery.
Material and Methods: Our study included 102 patients after lung surgery at the 74 Central Hospital from 9/2013 to 12/2017. Patients were divided into 2 groups: CTPB group (n= 51) and CTEB group (n= 51). The primary outcomes were the Visual Analogue Scale (VAS) scores when patients were at rest (VR) and movement (VM), the total used dosage of bupivacaine - fentanyl after surgery, plasma glucose, and cortisol levels, additional doses of morphine. Adverse reactions were recorded during the study. The study was approved by the Ethics Committee of the 74 Central Hospital. All participants provided their informed consent.
Results: There were no significant differences between CTPB and CTEB groups in terms of the VR and the VM, total used doses of bupivacaine - fentanyl after 72-hours of surgery (p> 0.05), the increased plasma glucose, and plasma cortisol (p> 0.05), and the additional doses of morphine. The percent of patients in the CTPB group undergoing adverse reactions in the circular system and the respiratory system was lower than in the CTEB group. Adverse reactions included vascular puncture, urinary retention, and itch.
Conclusion: Ultrasound-guided CTPB is an effective intervention of pain relief after lung surgery. Its analgesic efficacy is comparable to CTEB. Also, this method had fewer adverse reactions in circulation and respiration compared to the CTEB.
Keywords: Paravertebral block, analgesia, lung surgery, epidural block, postoperative pain
Cite this article as: Trung TT, Khoa DV, Dong TV. The comparison of analgesic efficacy between ultrasound-guided continuous thoracic paravertebral block and continuous thoracic epidural block using bupivacaine - fentanyl in patients undergoing lung surgery: A prospective, randomized, controlled trial. Turk J Surg 2021; 37 (3): 232-241.
The study was obtained from 74 Central Hospital Bromedical Studies Ethics Committee (No: 458/GCN-BV74TW).
Concept -T.T.T., T.V.D.; Design - T.T.T.; Supervision -T.V.D.; Materials - All of authors; Data Collection and/or Processing - T.T.T.; D.V.K.; Analysis and/or Interpretation - T.T.T.; D.V.K.; Literature Search- T.T.T.; D.V.K.; Writing Manuscript -T.T.T.; D.V.K.; Critical Reviews - T.T.T.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.