Garutti Martínez, IgnacioGonzález Aragoneses, FedericoBiencinto, MTNovoa, ESimón Adiego, Carlos MaríaMoreno Mata, NicolásCruz, PBenito, C.2024-02-092024-02-092009-05-01Garutti I, González-Aragoneses F, Biencinto MT, Novoa E, Simón C, Moreno N, Cruz P, Benito C. Thoracic paravertebral block after thoracotomy: comparison of three different approaches. Eur J Cardiothorac Surg. 2009 May;35(5):829-32. doi: 10.1016/j.ejcts.2009.01.025. Epub 2009 Mar 21.1010-794010.1016/j.ejcts.2009.01.025https://hdl.handle.net/20.500.14352/100652Background: 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).engjournal articlehttps://academic.oup.com/ejcts/article/35/5/829/464530?login=true19318275https://pubmed.ncbi.nlm.nih.gov/19318275/restricted access615.216.2Ciencias Biomédicas24 Ciencias de la Vida