Effects of thoracic paravertebral block with ropivacaine on pain and stress response after renal surgery

Abstract EN

Background: Renal surgery produces pain that is nociceptive and neuropathic in nature.

Pain from nephrectomy is mild to severe lasting days to weeks.

Objectives: The purpose of the present study is to evaluate thoracic paravertebral block (TPVB) analgesia to reduce pain after renal surgery.

Patients and methods: 32 patients undergoing major renal surgery were divided into two groups each of 16 patients.

Study group received TPVB analgesia in the form of 20 ml of ropivacaine 0.5% with adrenaline administered 30 minutes before skin incision.

Control group did not receive TPVB analgesia.

Both groups received morphine 0.1 mg/Kg IV 20 minutes before skin incision and patient controlled analgesia (PCA) post-operatively with morphine.

Results: The results revealed that in the TPVB analgesia group the mean total morphine consumption was significantly lower than the control group in the first 24 hours post-operative: 15 mg Vs 36 mg with P value <0.01.

The visual analogue scale (VAS) was significantly lower in TPVB group in comparison with control group up to 24 hours postoperative, at 12 hours post-operative, mean VAS at rest was 3.9 in TPVB group Vs 4.5 in control group.

Random blood sugar was lower in TPVB group in comparison with the control group.

Conclusion: Thoracic paravertebral block (TPVB) analgesia is a safe and effective method for postoperative analgesia in patients undergoing renal surgery as it reduced pain scores and attenuated stress response