Thoracic block for pain management after renal surgery
Thoracic paravertebral block (ThPVB) in combination with general anesthesia is known to provide effective analgesia for postoperative pain, and is therefore routinely used in thoracic and general surgery. In the present study, researchers at the Medical University of Silesia in Poland assess the efficacy of this method in patients undergoing renal surgery. The results: Not only did preoperative ThPVB reduce opioid consumption and pain intensity, but patients in this group also reported an increased satisfaction.
The study included 68 patients undergoing open nephrectomy or open nephron-sparing surgery. 27 patients had general anesthesia and ThPVB with 0.5 % bupivacaine, 31 patients received only general anesthesia (controls) (ten patients were not available for analysis). All patients received postoperative oxycodone and non-opioid analgesics as rescue drugs.
Compared to controls, ThPVB patients required 39 % less i.v. oxycodone in the first 48 hours and reported less pain at rest in the first 24 hours; they had fewer opioid-related adverse events and were less sedated in the first 12 hours. In addition, ThPVB patients reported higher satisfaction scores after 48 hours. No serious adverse events were noted.
Preoperative ThPVB constitutes an effective part of a multimodal analgesic regime. ThPVB reduces opioid consumption and pain, it is well tolerated and had no serious adverse events, summarize the authors.