Abstract
BackgroundTo investigate the feasibility, effectiveness and safety of bilateral thoracic paravertebral block (TPVB) in the post anesthesia care unit (PACU) for pain relief in participants after laparotomy.MethodsA single shot of bilateral TPVB with 25 ml of 0.2% ropivacaine and 5 mg dexamethasone in combination for both sides at the 8th thoracic transverse level (T8) was performed on 201 participants who complained moderate to severe pain on arrival to PACU after laparotomy. The visual analog scale (VAS) pain scores at rest and on cough, heart rate, blood pressure, and pulse oximetry before and after bilateral TPVB for up to 1 h were recorded. The VAS Pain scores at rest and on cough at 24 h after bilateral TPVB were also recorded.ResultsBilateral TPVB was carried out successfully in all participants. The VAS pain scores at rest and on cough were 7.9 ± 1.6 and 8.7 ± 1.3 respectively pre-bilateral TPVB. The VAS pain scores at rest and on cough were significantly decreased to 1.1 ± 1.2 and 2.1 ± 1.6 respectively (P < 0.001) at 60 min after bilateral TPVB and to 2.1 ± 1.7 and 3.8 ± 1.9 at rest and on cough respectively ((P < 0.001) at 24 h after bilateral TPVB. At 10 min post-bilateral TPVB, only systolic blood pressure was reduced from 122 ± 19 mmHg to 111 ± 18 mmHg (P = 0.007) but then gradually became stable. No complications related to bilateral TPVB were observed.ConclusionBilateral TPVB can be provided for pain relief to the participants who suffer from moderate to severe pain after upper laparotomy in the PACU.Trial registrationChinese Clinical Trial Registry: ChiCTR-ONN-16009229, Registered on 10 September 2016.
Highlights
To investigate the feasibility, effectiveness and safety of bilateral thoracic paravertebral block (TPVB) in the post anesthesia care unit (PACU) for pain relief in participants after laparotomy
Participants were informed that they would be offered bilateral TPVB to be performed in the PACU if they reported moderate to severe pain which was not controlled adequately by the intraoperative and PACU analgesia that they had received
No complications associated with the bilateral TPVB were observed in this study
Summary
Effectiveness and safety of bilateral thoracic paravertebral block (TPVB) in the post anesthesia care unit (PACU) for pain relief in participants after laparotomy. Good pain management improves participant satisfaction and facilitates shorter PACU/hospital stay [1]. Pain management in the PACU has been improving with opioid-free strategies, opioids are still commonly used of analgesia for surgical participants with moderate to severe pain [2]. It has been demonstrated that preoperative TPVB provides an excellent intraoperative and postoperative analgesia with less adverse effects in thoracic and abdominal surgery [7–12]. The effectiveness of TPVB as a rescue technique in the PACU for acute postoperative pain relief remains unknown. Participants in the PACU who suffer moderate to severe pain after
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
