A comparison of the incidence of supraventricular arrhythmias between thoracic paravertebral and intercostal nerve blocks in patients undergoing thoracoscopic surgery: A randomised trial.
Eur J Anaesthesiol
; 35(10): 792-798, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-29847363
ABSTRACT
BACKGROUND:
Postoperative supraventricular arrhythmias are common in patients after thoracoscopic lobectomy. Inadequate pain control has long been recognised as a significant risk factor for arrhythmias. The performance of ultrasound-guided (USG) thoracic paravertebral block (PVB) is increasing as an ideal technique for postoperative analgesia.OBJECTIVE:
We conducted this study to evaluate whether a single-shot USG thoracic PVB would result in fewer postoperative supraventricular tachycardias (SVT) than intercostal nerve blocks (ICNBs) after thoracoscopic pulmonary resection.DESIGN:
A randomised controlled study.SETTING:
A single university hospital. PATIENTS Sixty-eight patients undergoing thoracoscopic lobectomy were randomised into two equal groups of 34.INTERVENTIONS:
For postoperative pain control, all patients received a total of 0.3âmlâkg of a mixture containing 0.5% ropivacaine and 1/200â000 epinephrine after placement of needles for either a single thoracic PVB or two individual ICNBs, both guided by ultrasound. Data were obtained during the first 48 postoperative hours. MAIN OUTCOMEMEASURES:
The primary outcome was the incidence of SVT after thoracoscopic pulmonary resection.RESULTS:
During the first 48 postoperative hours, the incidences of SVT and atrial fibrillation were lower in the USG thoracic PVB group (14.7 vs. 46.9%, Pâ=â0.004 and 3.0 vs. 18.8%, Pâ=â0.037, respectively). The requirement for ß-receptor blockade was more frequent in the ICNBs group than in the PVB group (5.9 vs. 25%, Pâ=â0.033).CONCLUSION:
After placement of the needle using ultrasound guidance, a single-shot thoracic PVB is a well tolerated and effective technique to reduce the incidences of postoperative SVT and atrial fibrillation in patients undergoing thoracoscopic pulmonary resection. TRIAL REGISTRATION http//www.chictr.org/cn/, registration number ChiCTR-IOR-17010952.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
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Bloqueio Nervoso Autônomo
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Injeções Espinhais
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Cirurgia Torácica Vídeoassistida
/
Nervos Intercostais
Tipo de estudo:
Clinical_trials
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur J Anaesthesiol
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article