Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric Oncology
Objective: to enhance the efficiency and safety of anesthesia during thoracic surgical interventions in pediatric cancer surgery, by using general anesthesia in combination with thoracic paravertebral analgesia.Subjects and methods. A prospective, randomized trial was conducted. Intra- and postopera...
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| Format: | Article |
| Language: | English |
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2014-06-01
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| Series: | Общая реаниматология |
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| Online Access: | https://www.reanimatology.com/rmt/article/view/1341 |
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| author | E. I. Belousova N. V. Matinyan Z. S. Ordukhanyan |
| author_facet | E. I. Belousova N. V. Matinyan Z. S. Ordukhanyan |
| author_sort | E. I. Belousova |
| collection | DOAJ |
| description | Objective: to enhance the efficiency and safety of anesthesia during thoracic surgical interventions in pediatric cancer surgery, by using general anesthesia in combination with thoracic paravertebral analgesia.Subjects and methods. A prospective, randomized trial was conducted. Intra- and postoperative data were analyzed in 90 patients who had been operated on for lung and thoracic malignancies. There were two patient groups: 1) 50 children who used continuous thoracic paravertebral block (PVB) with ropivacaine 0.3% as part of combined balanced anesthesia and 2) 40 children who received epidural block with ropivacaine 0.2% as an analgesic component of combined anesthesia. All the patients underwent hemodynamic monitoring; postoperative pain assessment were carried out by a visual analogue scale (VAS) in children above 3 years of age and by the modified Douleur Aigue du Nouveau-ne (DAN) scale in those below the age of 3 years.Results. The trial has demonstrated that the analgesic effect during continuous PVB in the intra- and postoperative periods is comparable with that of epidural block with ropivacaine 0.2%; however, it has a higher hemodynamic stability. Ultrasound guided PVB has sufficient safety. The postoperative complications were pneumonia in 2 (4%) patients in the PVB group; these were associated with the baseline patient status in 5 (12.5%) children in the epidural analgesia group. Postoperative nausea was found in only 6% of the patients in the PVB group.Conclusion. The proposed modification of ropivacaine 0.3% injection into the paravertebral space under ultrasound guidance can increase the extent of the local anesthetic, thus enhancing the efficiency of PVB. The efficiency of the block is 98.1% versus 86% of the given by foreign authors. |
| first_indexed | 2024-04-10T01:28:17Z |
| format | Article |
| id | doaj.art-735b344287ce4e41a23a124238686250 |
| institution | Directory Open Access Journal |
| issn | 1813-9779 2411-7110 |
| language | English |
| last_indexed | 2024-04-10T01:28:17Z |
| publishDate | 2014-06-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj.art-735b344287ce4e41a23a1242386862502023-03-13T09:32:53ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102014-06-01102576510.15360/1813-9779-2014-2-57-651341Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric OncologyE. I. Belousova0N. V. Matinyan1Z. S. Ordukhanyan2НИИ детской онкологии и гематологии Российский онкологический научный центр им. Н. Н. Блохина РАМН, МоскваНИИ детской онкологии и гематологии Российский онкологический научный центр им. Н. Н. Блохина РАМН, МоскваНИИ детской онкологии и гематологии Российский онкологический научный центр им. Н. Н. Блохина РАМН, МоскваObjective: to enhance the efficiency and safety of anesthesia during thoracic surgical interventions in pediatric cancer surgery, by using general anesthesia in combination with thoracic paravertebral analgesia.Subjects and methods. A prospective, randomized trial was conducted. Intra- and postoperative data were analyzed in 90 patients who had been operated on for lung and thoracic malignancies. There were two patient groups: 1) 50 children who used continuous thoracic paravertebral block (PVB) with ropivacaine 0.3% as part of combined balanced anesthesia and 2) 40 children who received epidural block with ropivacaine 0.2% as an analgesic component of combined anesthesia. All the patients underwent hemodynamic monitoring; postoperative pain assessment were carried out by a visual analogue scale (VAS) in children above 3 years of age and by the modified Douleur Aigue du Nouveau-ne (DAN) scale in those below the age of 3 years.Results. The trial has demonstrated that the analgesic effect during continuous PVB in the intra- and postoperative periods is comparable with that of epidural block with ropivacaine 0.2%; however, it has a higher hemodynamic stability. Ultrasound guided PVB has sufficient safety. The postoperative complications were pneumonia in 2 (4%) patients in the PVB group; these were associated with the baseline patient status in 5 (12.5%) children in the epidural analgesia group. Postoperative nausea was found in only 6% of the patients in the PVB group.Conclusion. The proposed modification of ropivacaine 0.3% injection into the paravertebral space under ultrasound guidance can increase the extent of the local anesthetic, thus enhancing the efficiency of PVB. The efficiency of the block is 98.1% versus 86% of the given by foreign authors.https://www.reanimatology.com/rmt/article/view/1341паравертебральная блокада, ропивакаин, детская онкология, послеоперационный период |
| spellingShingle | E. I. Belousova N. V. Matinyan Z. S. Ordukhanyan Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric Oncology Общая реаниматология паравертебральная блокада, ропивакаин, детская онкология, послеоперационный период |
| title | Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric Oncology |
| title_full | Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric Oncology |
| title_fullStr | Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric Oncology |
| title_full_unstemmed | Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric Oncology |
| title_short | Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric Oncology |
| title_sort | thoracic paravertebral block for postoperative analgesia in pediatric oncology |
| topic | паравертебральная блокада, ропивакаин, детская онкология, послеоперационный период |
| url | https://www.reanimatology.com/rmt/article/view/1341 |
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