Efficacy and Safety of Paravertebral Block vs Intercostal Nerve Block in Thoracic and Breast Surgery
A recent systematic review and meta-analysis has shed light on the efficacy and safety of paravertebral block (PVB) versus intercostal nerve block (INB) in thoracic surgery and breast surgery. This analysis provides valuable insights for medical professionals in making informed decisions about pain management strategies.
PVB and INB after open cholecystectomy surgery reduced postoperative pain.
PVB and INB reduced total analgesic dose requirements.
PVB were effective analgesic on coughing on postoperative period than INB.
TPVB and INB are a valuable alternative for open cholecystectomy pain management.
The study was conducted by searching PubMed, Web of Science, Embase, and the Cochrane Library up to February 2020 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy and safety of PVB compared with INB after thoracic surgery and breast surgery.
The primary outcome of the study showed no significant differences between the two groups with respect to postoperative visual analogue scale (VAS) at various time intervals. However, there was a significant difference in VAS of non-Chinese subgroup at 1h and VAS of Chinese subgroup at 24h.
In terms of secondary outcomes, the analysis also showed no significant difference between the groups according to the rates of postoperative nausea and vomit and the rates of postoperative additional analgesia. However, there was a significant difference in postoperative consumption of morphine.
The study concluded that compared with INB, PVB can provide better analgesia efficacy and cause lower consumption of morphine after thoracic surgery and breast surgery. This conclusion is supported by another study which reached a consensus that PVB was more effective than INB, citing lower postoperative morphine use and better patient satisfaction with postoperative analgesia.
The findings from this systematic review and meta-analysis have important implications for pain management in thoracic and breast surgeries. They suggest that PVB may be a more effective method for managing postoperative pain compared to INB. This could potentially lead to improved patient comfort, satisfaction, and overall recovery outcomes.
However, as with all medical procedures, it's important to consider individual patient characteristics, surgical factors, and potential risks when deciding on an analgesic strategy. Further research is needed to confirm these findings and explore other potential benefits or drawbacks of these two methods.
In conclusion, this systematic review and meta-analysis provides valuable insights into the efficacy and safety of PVB versus INB in thoracic surgery and breast surgery. It highlights the potential benefits of PVB in providing superior analgesia efficacy and lower morphine consumption postoperatively.
For complete article:
Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis
Sheng Huan,Youming Deng,Jia Wang,Yihao Ji,Guoping Yin
Published: October 5, 2020