%0 Journal Article
%A Garutti Martínez, Ignacio
%A González Aragoneses, Federico
%A Biencinto, MT
%A Novoa, E
%A Simón Adiego, Carlos María
%A Moreno Mata, Nicolás
%A Cruz, P
%A Benito, C.
%T Thoracic paravertebral block after thoracotomy: comparison of three different approaches
%D 2009
%@ 1010-7940
%U https://hdl.handle.net/20.500.14352/100652
%X Background: Thoracic paravertebral block (TPVB) is a regional block technique increasingly used for the early management of post-thoracotomy pain. We compare three different postoperative analgesic approaches based on TPVB: anesthetist, anesthetist plus surgeon, and surgeon.Materials and methods: We randomized 54 patients undergoing elective thoracotomy to three different postoperative analgesia groups: paravertebral percutaneous catheter (PVA group), paravertebral percutaneous catheter plus incisional (subcutaneous) catheter (PVA+Inc), and paravertebral catheter under direct vision (PVS group). During early postoperative 48h, we measured pain intensity, intravenous morphine afforded by the patient-controlled analgesia pump, and the spirometric test.Results: There were no statistically significant differences among the collected preoperative data. No significant differences were observed on postoperative spirometric values. Analgesic quality was better in PVA+Inc group at 12 and 24 postoperative hours. In this group, intravenous morphine use to improve analgesia was significantly lower from 8h until 48h postoperative.Conclusions: Association of thoracic paravertebral block to continuous infusion of a local anesthetic in the surgical incision area affords a better pain relief than paravertebral block alone (introduced by the surgeon or the anesthetist).
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