Comparative study between ultrasound-guided thoracic paravertebral nerve block and intraperitoneal instillation of local anesthetic as pre-emptive analgesia in laparoscopic cholecystectomy surgery
Joint Authors
Abd Allah, Asma S.
Ashur, Fatimah H.
al-Shanawani, Inas M. A.
Source
Ain Shams Journal of Anesthesiology
Issue
Vol. 10, Issue 1 (31 Mar. 2017), pp.272-278, 7 p.
Publisher
Ain Shams University Faculty of Medicine Department of Anesthesiology
Publication Date
2017-03-31
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background Thoracic paravertebral block (TPVB) is an effective technique in controlling pain after lower thoracic and upper abdominal surgery, and ultrasound guidance is a recent technique that may offer several advantages.
Intraperitoneal injections of local anesthetics have been proposed to minimize postoperative pain after laparoscopic surgery.
Patients and methods A total of 60 patients with American Society of Anesthesiologists status I and II aged 30–50 years undergoing elective laparoscopic cholecystectomy were divided into three equal groups (20 patients each): ultrasound-guided thoracic paravertebral block (UG-TPVB group) with 20 ml 0.25% bupivacaine bilaterally, intraperitoneal instillation of local anesthetics with 50 ml 0.25% bupivacaine after inflation of the abdomen with gas (IP group), and general anesthesia alone without any local anesthetics (GA group) (control group).
General anesthesia was induced for all patients.
Intraoperative and postoperative hemodynamic data (mean arterial blood pressure and heart rate) were recorded.
Intraoperative anesthetic and analgesic consumption, pain intensity using visual analog scale, pethidine consumption, serum cortisol, blood glucose level, and complications were estimated.
Results Hemodynamic data were significantly lower in IP and UG-TPVB groups compared with GA group (P<0.05), and on comparing UG-TPVB group with IP group, with no significant difference was seen regarding postanaesthesia care unit admission and discharge (P1>0.05).
End-tidal sevoflurane % (UG-TPVB: 1.1±0.21, IP: 1.8±0.22, GA: 2±0.23) and volume of consumption (UG-TPVB: 12.0±0.9, IP: 15.1±0.7, GA: 18.2±2) showed significant decrease when comparing UG-TPVB and IP groups with GA group (P<0.05).
The mean dose of intraoperative fentanyl, mean dose of postoperative pethidine consumption, and the number of patients who received pethidine were significantly lower in IP and UG-TPVB groups compared with GA group (P<0.05).
Postoperative serum cortisol and blood glucose level showed significant decrease in UG-TPVB and IP groups compared with GA group at 6 and 24 h postoperative (P<0.05).
Pain score using visual analog scale and number of patients who experienced postoperative nausea and vomiting were significantly decreased in both groups in comparison with GA group.
Conclusion UG-TPVB and IP bupivacaine instillation as pre-emptive analgesia in laparoscopic cholecystectomy provided good intraoperative and postoperative analgesia and decreased the dose of anesthetics used with great safety, and the incidence of complications was less.
American Psychological Association (APA)
Abd Allah, Asma S.& Ashur, Fatimah H.& al-Shanawani, Inas M. A.. 2017. Comparative study between ultrasound-guided thoracic paravertebral nerve block and intraperitoneal instillation of local anesthetic as pre-emptive analgesia in laparoscopic cholecystectomy surgery. Ain Shams Journal of Anesthesiology،Vol. 10, no. 1, pp.272-278.
https://search.emarefa.net/detail/BIM-841396
Modern Language Association (MLA)
Abd Allah, Asma S.…[et al.]. Comparative study between ultrasound-guided thoracic paravertebral nerve block and intraperitoneal instillation of local anesthetic as pre-emptive analgesia in laparoscopic cholecystectomy surgery. Ain Shams Journal of Anesthesiology Vol. 10, no. 1 (Mar. 2017), pp.272-278.
https://search.emarefa.net/detail/BIM-841396
American Medical Association (AMA)
Abd Allah, Asma S.& Ashur, Fatimah H.& al-Shanawani, Inas M. A.. Comparative study between ultrasound-guided thoracic paravertebral nerve block and intraperitoneal instillation of local anesthetic as pre-emptive analgesia in laparoscopic cholecystectomy surgery. Ain Shams Journal of Anesthesiology. 2017. Vol. 10, no. 1, pp.272-278.
https://search.emarefa.net/detail/BIM-841396
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 278
Record ID
BIM-841396