Paravertebral block via the surgical field versus epidural block for patients undergoing thoracotomy: a randomized clinical trial
Purpose A paravertebral block (PVB) given via the surgical field can be safer and technically simpler than an epidural block (EP) for postoperative pain control. We conducted this clinical trial to confirm the effectiveness of PVB after thoracotomy. Methods In this non-inferiority trial, patients we...
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Published in | Surgery today (Tokyo, Japan) Vol. 43; no. 9; pp. 963 - 969 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Tokyo
Springer Japan
01.09.2013
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Abstract | Purpose
A paravertebral block (PVB) given via the surgical field can be safer and technically simpler than an epidural block (EP) for postoperative pain control. We conducted this clinical trial to confirm the effectiveness of PVB after thoracotomy.
Methods
In this non-inferiority trial, patients were randomly assigned to receive PVB (
n
= 35) or EP (
n
= 35). The primary endpoint was the pain assessed using the visual analog scale (VAS) at rest, 2, 24, and 48 h after thoracotomy, with the non-inferiority margin set at 15 mm. The secondary end points were the pain assessed using the VAS on exercising and on coughing, 2, 24, and 48 h after surgery, respectively, and the complications and need for additional analgesic agents.
Results
This trial revealed that PVB was not inferior to EP with respect to the primary end point: The mean VAS scores at rest, 2, 24, and 48 h after thoracotomy were 26.3, 10.8, and 8.3 mm in the PVB group and 23.6, 12.4, and 12.6 mm in the EP group, respectively (
P
< 0.01 for non-inferiority at all points). There were no significant differences between the groups in the incidence of complications or the need for additional analgesic agents.
Conclusion
PVB may replace EP for postoperative pain control because of its technical simplicity and safety. |
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AbstractList | PURPOSEA paravertebral block (PVB) given via the surgical field can be safer and technically simpler than an epidural block (EP) for postoperative pain control. We conducted this clinical trial to confirm the effectiveness of PVB after thoracotomy. METHODSIn this non-inferiority trial, patients were randomly assigned to receive PVB (n = 35) or EP (n = 35). The primary endpoint was the pain assessed using the visual analog scale (VAS) at rest, 2, 24, and 48 h after thoracotomy, with the non-inferiority margin set at 15 mm. The secondary end points were the pain assessed using the VAS on exercising and on coughing, 2, 24, and 48 h after surgery, respectively, and the complications and need for additional analgesic agents. RESULTSThis trial revealed that PVB was not inferior to EP with respect to the primary end point: The mean VAS scores at rest, 2, 24, and 48 h after thoracotomy were 26.3, 10.8, and 8.3 mm in the PVB group and 23.6, 12.4, and 12.6 mm in the EP group, respectively (P < 0.01 for non-inferiority at all points). There were no significant differences between the groups in the incidence of complications or the need for additional analgesic agents. CONCLUSIONPVB may replace EP for postoperative pain control because of its technical simplicity and safety. A paravertebral block (PVB) given via the surgical field can be safer and technically simpler than an epidural block (EP) for postoperative pain control. We conducted this clinical trial to confirm the effectiveness of PVB after thoracotomy. In this non-inferiority trial, patients were randomly assigned to receive PVB (n = 35) or EP (n = 35). The primary endpoint was the pain assessed using the visual analog scale (VAS) at rest, 2, 24, and 48 h after thoracotomy, with the non-inferiority margin set at 15 mm. The secondary end points were the pain assessed using the VAS on exercising and on coughing, 2, 24, and 48 h after surgery, respectively, and the complications and need for additional analgesic agents. This trial revealed that PVB was not inferior to EP with respect to the primary end point: The mean VAS scores at rest, 2, 24, and 48 h after thoracotomy were 26.3, 10.8, and 8.3 mm in the PVB group and 23.6, 12.4, and 12.6 mm in the EP group, respectively (P < 0.01 for non-inferiority at all points). There were no significant differences between the groups in the incidence of complications or the need for additional analgesic agents. PVB may replace EP for postoperative pain control because of its technical simplicity and safety. Purpose A paravertebral block (PVB) given via the surgical field can be safer and technically simpler than an epidural block (EP) for postoperative pain control. We conducted this clinical trial to confirm the effectiveness of PVB after thoracotomy. Methods In this non-inferiority trial, patients were randomly assigned to receive PVB ( n = 35) or EP ( n = 35). The primary endpoint was the pain assessed using the visual analog scale (VAS) at rest, 2, 24, and 48 h after thoracotomy, with the non-inferiority margin set at 15 mm. The secondary end points were the pain assessed using the VAS on exercising and on coughing, 2, 24, and 48 h after surgery, respectively, and the complications and need for additional analgesic agents. Results This trial revealed that PVB was not inferior to EP with respect to the primary end point: The mean VAS scores at rest, 2, 24, and 48 h after thoracotomy were 26.3, 10.8, and 8.3 mm in the PVB group and 23.6, 12.4, and 12.6 mm in the EP group, respectively ( P < 0.01 for non-inferiority at all points). There were no significant differences between the groups in the incidence of complications or the need for additional analgesic agents. Conclusion PVB may replace EP for postoperative pain control because of its technical simplicity and safety. |
Author | Hosoda, Renko Fukumoto, Koichi Saito, Takuya Nakata, Junya Mori, Shoichi Fukui, Takayuki Abe, Tetsuya Hatooka, Shunzo Kobayashi, Rei Wakai, Kenji Mitsudomi, Tetsuya Ito, Simon Katayama, Tatsuya |
Author_xml | – sequence: 1 givenname: Rei surname: Kobayashi fullname: Kobayashi, Rei email: chinosenar@gmail.com, zkoba@saichu.jp organization: Department of Thoracic Surgery, Saiseikai Central Hospital – sequence: 2 givenname: Shoichi surname: Mori fullname: Mori, Shoichi organization: Department of Thoracic Surgery, Nagoya First Red Cross Hospital – sequence: 3 givenname: Kenji surname: Wakai fullname: Wakai, Kenji organization: Department of Preventive Medicine, Nagoya University Graduate School of Medicine – sequence: 4 givenname: Koichi surname: Fukumoto fullname: Fukumoto, Koichi organization: Department of Thoracic Surgery, Aichi Cancer Center Hospital – sequence: 5 givenname: Takuya surname: Saito fullname: Saito, Takuya organization: Department of Thoracic Surgery, Aichi Cancer Center Hospital – sequence: 6 givenname: Tatsuya surname: Katayama fullname: Katayama, Tatsuya organization: Department of Thoracic Surgery, Aichi Cancer Center Hospital – sequence: 7 givenname: Junya surname: Nakata fullname: Nakata, Junya organization: Department of Anesthesiology, Aichi Cancer Center Hospital – sequence: 8 givenname: Takayuki surname: Fukui fullname: Fukui, Takayuki organization: Department of Thoracic Surgery, Aichi Cancer Center Hospital – sequence: 9 givenname: Simon surname: Ito fullname: Ito, Simon organization: Department of Thoracic Surgery, Aichi Cancer Center Hospital – sequence: 10 givenname: Tetsuya surname: Abe fullname: Abe, Tetsuya organization: Department of Thoracic Surgery, Aichi Cancer Center Hospital – sequence: 11 givenname: Shunzo surname: Hatooka fullname: Hatooka, Shunzo organization: Department of Thoracic Surgery, Aichi Cancer Center Hospital – sequence: 12 givenname: Renko surname: Hosoda fullname: Hosoda, Renko organization: Department of Anesthesiology, Aichi Cancer Center Hospital – sequence: 13 givenname: Tetsuya surname: Mitsudomi fullname: Mitsudomi, Tetsuya organization: Department of Thoracic Surgery, Aichi Cancer Center Hospital |
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Cites_doi | 10.1093/bja/83.3.387 10.1016/0003-4975(95)00058-S 10.1093/bja/ael020 10.1378/chest.121.6.1890 10.1016/0022-3468(92)90444-C 10.1016/S0304-3959(01)00349-9 10.1093/bja/75.4.405 10.1016/0003-4975(91)90850-P 10.1097/00000542-194105000-00004 10.1213/00000539-199803000-00032 10.1097/00115550-200411000-00013 |
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A paravertebral block (PVB) given via the surgical field can be safer and technically simpler than an epidural block (EP) for postoperative pain... A paravertebral block (PVB) given via the surgical field can be safer and technically simpler than an epidural block (EP) for postoperative pain control. We... PURPOSEA paravertebral block (PVB) given via the surgical field can be safer and technically simpler than an epidural block (EP) for postoperative pain... |
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SubjectTerms | Adult Aged Anesthesia, Epidural Female Humans Male Medicine Medicine & Public Health Middle Aged Nerve Block - methods Original Article Pain, Postoperative - diagnosis Pain, Postoperative - prevention & control Surgery Surgical Oncology Thoracotomy Time Factors Young Adult |
Title | Paravertebral block via the surgical field versus epidural block for patients undergoing thoracotomy: a randomized clinical trial |
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