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Investigation of single-dose thoracic paravertebral analgesia for postoperative pain control after thoracoscopic lobectomy - A randomized controlled trial.
- Source :
- International Journal of Surgery; Sep2018, Vol. 57, p8-14, 7p
- Publication Year :
- 2018
-
Abstract
- <bold>Background: </bold>Thoracoscopic lobectomy is less painful than normal thoracotomy, but pain management is still an issue in the postoperative period. Thoracic epidural analgesia (TEA) is considered as the gold standard for post-thoracotomy pain control, but is associated with numerous risks.<bold>Methods: </bold>A total of 114 patients undergoing thoracoscopic lobectomy were randomly divided into three groups. Patients in the PVB-R group received a single-dose 0.5% ropivacaine paravertebral block (PVB), combined with patient-controlled intravenous analgesia (PCIA) after extubation during the 48-h postoperative period; those in the PVB-RD group received a single-dose 0.5% ropivacaine and dexmedetomidine (1 μg/kg) PVB, combined with the same PCIA scheme; and those in the TEA group received intraoperative thoracic epidural anesthesia with 0.5% ropivacaine, and a single dose of epidural morphine (0.03 mg/kg) after extubation combined with the same PCIA scheme. The dose and first time of postoperative analgesia, verbal rating score (VRS), change in catecholamine, cortisol and cytokine levels, change in hemodynamic parameters, and side effects during the postoperative period were recorded.<bold>Results: </bold>Compared to the PVB-R group, the dose of postoperative analgesia and VRS were lower and the first time of postoperative analgesia were longer in the PVB-RD and TEA group. Patients in the PVB-RD group had a lower incidence of side effects compared to those in the TEA group.<bold>Conclusions: </bold>Single-dose 0.5% ropivacaine combined with dexmedetomidine (1 μg/kg) PVB provides satisfactory postoperative pain control after thoracoscopic lobectomy, and can reduce the incidence of postoperative side effects. [ABSTRACT FROM AUTHOR]
- Subjects :
- PAIN management
AMIDES
ANALGESICS
COMPARATIVE studies
IMIDAZOLES
LONGITUDINAL method
RESEARCH methodology
INTRAOPERATIVE care
MEDICAL cooperation
MORPHINE
NERVE block
EPIDURAL anesthesia
PNEUMONECTOMY
POSTOPERATIVE pain
POSTOPERATIVE period
RESEARCH
THORACOSCOPY
EVALUATION research
RANDOMIZED controlled trials
TREATMENT effectiveness
Subjects
Details
- Language :
- English
- ISSN :
- 17439191
- Volume :
- 57
- Database :
- Supplemental Index
- Journal :
- International Journal of Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 131608499
- Full Text :
- https://doi.org/10.1016/j.ijsu.2018.07.006