2021-09-102021-09-102006Kaya, F. N. vd. (2006). 'Preoperative multiple-injection thoracic paravertebral blocks reduce postoperative pain and analgesic requirements after video-assisted thoracic surgery''. Journal of Cardiothoracic and Vascular Anesthesia, 20(5), 639-643.1053-07701532-8422https://doi.org/10.1053/j.jvca.2006.03.022https://www.sciencedirect.com/science/article/pii/S105307700600156Xhttp://hdl.handle.net/11452/21853Objective: The hypothesis was tested that preoperative multiple-injection thoracic paravertebral blocks reduce opioid requirements and promote early ambulation after video-assisted thoracic surgery procedures. Design: Prospective, randomized, controlled, blinded study. Setting: Single-university hospital. Participants: Fifty consenting patients undergoing video-assisted thoracic surgery. Interventions: Patients were randomly assigned to receive preoperative multiple-injection thoracic paravertebral blocks (PVB group, n = 25) or preoperative multiple subcutaneous saline injections at the same site as in the PVB group (control group, n = 25). Measurements and Main Results: Intraoperative fentanyl consumption was lower in the PVB group (p < 0.01). The time to first analgesic requirement was longer, and pain score at this time was lower in the PVB group (p < 0.05 and p < 0.01, respectively). Postoperative pain scores both at rest and coughing were lower during the first 4 hours in the PVB group than those in the control group (p < 0.01 for 0 hours and p < 0.05 for 1, 2, and 4 hours). Cumulative morphine consumption was significantly less in the PVB group at all time points (p < 0.05 for 12 hours and p < 0.01 for all other time points), but there were no significant differences in sedation scores between the 2 groups. There were no complications because of the blocks. Patient satisfaction with the analgesia was significantly greater (p < 0.05), and first mobilization and hospital discharge were quicker (p < 0.01 and p < 0.05, respectively) in the PVB group. Conclusion: Perioperative multiple-injection'thoracic paravertebral blocks with bupivacaine containing epinephrine provided effective pain relief and a significant reduction in opioid requirements. This approach may also contribute to earlier postoperative ambulation after video-assisted thoracic surgery.eninfo:eu-repo/semantics/closedAccessAnesthesiologyCardiovascular system & cardiologyRespiratory systemThoracic paravertebral blocksPostoperative analgesiaThoracoscopic surgerySpaceManagementThoracotomyThoracoscopic surgeryArticle0002412615000022-s2.0-3374911801063964320517023279AnesthesiologyCardiac & cardiovascular systemsRespiratory systemPeripheral vascular diseaseThoracic Nerves; Modified Radical Mastectomy; Thoracotomy