4^th International Anesthesia and Pain Medicine Conference

Introduction: Thoracic epidural analgesia (TEA) is considered the gold standard in patients undergoing thoracotomy; however, paravertebral block (PVB) is considered a valid alternative with lower incidence of side effects. With the increase of minimal invasive thoracic surgery and introducing the enhance recovery after surgery, PVB becomes the first choice of analgesia. We present our results of differnet analgesia techniques in patient underwent thoracotomy in one of the largiest hospital for thoracic surgery in London, UK.

 

Method: Patients underwent thoracotomy from March 2016 to March 2017 were prospectively reviewed and categorized based on analgesia techniques: Epidural with local Anesthetic (LA) and opioid, Epidural with only LA with addition patient controlled analgesia (PCA), paravertebral block (PVB) with PCA. We analysed the pain control, complications and length of stay.

 

Result: 137 patients underwent thoracotomy; 54 had thoracic epidural with LA and opioid, 32 epidural with LA with additional PCA and 52 PVB with additional PCA. There was no significance difference between the three groups in sex, age and weight.

There was no significant difference between the three groups in the pain score immediately after surgery (P=0.41); however,there was no significance difference between the three groups in the pain score in the first 24 hours (P=0.024). Interestingly there was no significant difference between the three groups in complications: Nausea, vomiting, urinary retention and constipation.

 

Conclusion: PVB is a valid alternative for TEA in patients undergoing thoracotomy. However, considering the increase minimal invasive surgery techniques in thoracic surgery, PVB should be the first choice to promote the enhance recovery after surgery.