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Preoperative vs. Postoperative Bilateral Paravertebral Blocks for Laparoscopic Cholecystectomy: A Prospective Randomized Clinical Trial
Author(s) -
Naja Zoher M.,
ElRajab Mariam,
Ziade Fouad,
AlTannir Mohamad,
Itani Taha
Publication year - 2011
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2011.00447.x
Subject(s) - medicine , visual analogue scale , blockade , anesthesia , randomized controlled trial , surgery , laparoscopic cholecystectomy , analgesic , cholecystectomy , postoperative pain , nerve block , receptor
Background: The aim of this clinical trial was to determine the potential analgesic effect of preoperative paravertebral blockade in patients undergoing laparoscopic cholecystectomy. Methods: Sixty patients scheduled for laparoscopic cholecystectomy were randomized to one of two groups with 30 patients each: bilateral nerve stimulator guided paravertebral blockade at the T5 to T6 level either prior to induction of general anesthesia (Group 1) or blockade immediately postoperatively (Group 2). Results: The preoperative paravertebral block group had significantly lower visual analog scale scores compared with the postoperative paravertebral block group both at rest 12 hours postoperatively (1.06 vs. 1.89; P < 0.05), on movement 12 hours postoperatively (1.89 vs. 3.00; P < 0.001) and on coughing 12 hours postoperatively (2.24 vs. 3.17; P < 0.01). The consumption of analgesics as well as the duration of hospital stay was significantly reduced in patients receiving preoperative paravertebral blocks ( P < 0.05). [Correction added after online publication 27th May 2011: visual analog scores were amended] Conclusion: Bilateral paravertebral blockade performed prior to general anesthesia for laparoscopic cholecystectomy can provide early discharge and better postoperative pain management.