paravertebral block versus epidural anesthesia for lower abdominal surgeries
Joint Authors
Abu Salimah, Ashraf A.
Bestarous, John N.
Source
Ain Shams Journal of Anesthesiology
Issue
Vol. 6, Issue 3 (31 Dec. 2013), pp.275-281, 7 p.
Publisher
Ain Shams University Faculty of Medicine Department of Anesthesiology
Publication Date
2013-12-31
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Topics
Abstract EN
Background Paravertebral block provides effective intraoperative and postoperative analgesia for many thoracic and abdominal surgeries both in children and in adults.
This technique has a low failure rate, fewer complications, and can be unilaterally used in unilateral procedures and whenever epidural anesthesia is contraindicated.
We aimed to compare the anesthetic effectiveness of a paravertebral block with epidural anesthesia in lower abdominal procedures.
Patients and methods This prospective study included 60 patients who underwent different lower abdominal surgeries, divided into two equal groups: group I [lumbar epidural (LE) group] received LE anesthesia and group II [thoracolumbar paravertebral (TLP) group] received a unilateral TLP block.
In both groups, the anesthetic regimen was a single injection of bupivacaine 0.5 % (10–14 ml) for intraoperative anesthesia, followed by bupivacaine 0.125 % (10–14 ml) every 8 h or according to the patient’s needs for postoperative analgesia.
Patients were assessed for hemodynamic parameters (heart rate and mean arterial pressure), motor blockade (Bromage scale), intensity of pain (visual analogue scale), the stress response (perioperative changes in serum glucose and adrenaline levels), and any perioperative complications.
Assessment started from the onset of the block and continued for the first 24 h postoperatively.
Results Visual analogue scale (pain) scores were lower (better) in the TLP group at all times; the differences were statistically significant (Po0.05) at 1, 2, and 8 h after block, whereas they were comparable (P40.05) at 4, 6, 10, 12, 18, and 24 h.
Only one patient (3.33%) in the TLP group and two (6.67 %) in the LE group required systemic analgesic supplementation postoperatively (P40.05).
Motor block was predominant in the LE group at 1, 2 (Po0.001), and 4 h (Po0.05) after block.
Hemodynamic stability was better in the TLP group.
Only one patient had intraoperative hypotension in the TLP group compared with three in the LE group (P40.05).
Serum glucose and adrenaline levels were lower in the TLP group at almost all times, with comparable results (P40.05).
Both techniques were uncomplicated.
Conclusion Paravertebral blockade provided higher quality intraoperative and postoperative analgesia, and offered better modification of the stress response and a better side effect/complication profile than epidural anesthesia; however, the results were generally comparable.
American Psychological Association (APA)
Abu Salimah, Ashraf A.& Bestarous, John N.. 2013. paravertebral block versus epidural anesthesia for lower abdominal surgeries. Ain Shams Journal of Anesthesiology،Vol. 6, no. 3, pp.275-281.
https://search.emarefa.net/detail/BIM-650137
Modern Language Association (MLA)
Abu Salimah, Ashraf A.& Bestarous, John N.. paravertebral block versus epidural anesthesia for lower abdominal surgeries. Ain Shams Journal of Anesthesiology Vol. 6, no. 3 (Sep. / Dec. 2013), pp.275-281.
https://search.emarefa.net/detail/BIM-650137
American Medical Association (AMA)
Abu Salimah, Ashraf A.& Bestarous, John N.. paravertebral block versus epidural anesthesia for lower abdominal surgeries. Ain Shams Journal of Anesthesiology. 2013. Vol. 6, no. 3, pp.275-281.
https://search.emarefa.net/detail/BIM-650137
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 281
Record ID
BIM-650137