The analgesic efficacy of a single injection of ultrasound-guided retrolaminar paravertebral block for breast surgery: a prospective, randomized, double-blinded study

Background: Prostate biopsy is a painful procedure, and the degree of pain is related to the number of core biopsies taken. Objective: To compare the analgesic properties of hyperbaric bupivacaine 0.25% with 0.375% ropivacaine for saddle block in transrectal prostate biopsy. Methods: This was a randomised double-blinded study. Eighty patients with indications for prostate biopsy presenting at the Day-Case Theatre in a Nigerian tertiary facility were randomised into two equal groups: B (Bupivacaine) and R (Ropivacaine). Group B received 1ml of 0.25% bupivacaine, while Group R received 1ml of 0.375% ropivacaine for saddle block, respectively. Pain assessment, home readiness, patients' satisfaction, and time to first analgesic request were assessed and compared between the two groups. Results: The Bupivacaine group had an earlier onset of sensory block (11.90±4.10 minutes vs 23.70±8.65 minutes, p = 0.000), slower sensory block regression (48.73±9.32 minutes vs 24.88±4.21 minutes, p = 0.000), but delayed home readiness (47.23±15.93 minutes vs 29.88±8.58 minutes, p = 0.000), than patients in the Ropivacaine group. The pain scores during, immediately after and 30 minutes post-biopsy were lower in the Bupivacaine group: p = 0.010, p = 0.028 and p = 0.023 respectively. The time to first analgesic request was also longer in the Bupivacaine group (48.73±9.33 minutes) than for those in the Ropivacaine group (24.88±4.21 minutes) with statistical significance (p = 0.000). Conclusion: Intraoperative analgesic properties were better in the Bupivacaine group than in the Ropivacaine group. However, home readiness was earlier in the Ropivacaine group.

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A Prospective Randomized Observer-Blinded Study to Assess Postoperative Analgesia Provided by an Ultrasound-Guided Bilateral Thoracic Paravertebral Block for Children Undergoing the Nuss Procedure

Regional Anesthesia and Pain Medicine ◽

10.1097/aap.0000000000000071 ◽

2014 ◽

Vol 39 (3) ◽

pp. 208-213 ◽

Cited By ~ 24

Author(s):

Jiashan Qi ◽

Bin Du ◽

Harshad Gurnaney ◽

Peilin Lu ◽

Yunxia Zuo

Keyword(s):

Postoperative Analgesia ◽

Paravertebral Block ◽

Nuss Procedure ◽

Ultrasound Guided ◽

Thoracic Paravertebral Block ◽

Blinded Study

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Analgesic Efficacy of Paracetamol in Children Using Tonsillectomy as a Pain Model

Anaesthesia and Intensive Care ◽

10.1177/0310057x9602400606 ◽

1996 ◽

Vol 24 (6) ◽

pp. 669-673 ◽

Cited By ~ 88

Author(s):

B. Anderson ◽

S. Kanagasundarum ◽

G. Woollard

Keyword(s):

Pain Score ◽

Venous Blood ◽

Analgesic Efficacy ◽

Temperature Plasma ◽

Paracetamol Concentration ◽

Blinded Study ◽

Group A ◽

Group B ◽

Double Blinded ◽

Induction Of Anaesthesia

The analgesic efficacy of paracetamol was assessed in a prospective, randomized, double-blinded study of 100 children undergoing tonsillectomy with or without adenoidectomy. Fifty children were given paracetamol elixir 40 mg/kg 40 minutes preoperatively (Group A); the remaining 50 children were given an oral placebo 40 minutes pre-operatively and paracetamol suppositories 40 mg/kg after induction of anaesthesia (Group B). Paracetamol was the only analgesic given and was given either orally or rectally in order to produce high variations in plasma paracetamol concentrations postoperatively. At 30 minutes after the end of surgery a pain score (0–10) was obtained and a venous blood sample was taken for serum paracetamol concentration analysis. Children given paracetamol elixir had a higher mean paracetamol concentration (0.15 [SD 0.06] mmol/l vs 0.05 [SD 0.03] mmol/l, P < 0.001) and a lower median pain score (5 vs 7, P < 0.02) than those who were given suppositories. The use of rescue morphine was higher (10 vs 23, P < 0.001) in the latter group. The incidence of nausea and vomiting was the same in both groups (20%) during the 24 hour postoperative period. Plasma paracetamol concentrations of 0.066–0.132 mmol/l are known to reduce temperature; plasma paracetamol concentrations which provide analgesia are unknown. Children with plasma paracetamol concentrations above 0.07 mmol/l had superior analgesia to those with concentrations below this level (P < 0.05).

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Comparison between the analgesic efficacy of transversus abdominis plane (TAP) block and placebo in open retropubic radical prostatectomy: a prospective, randomized, double-blinded study

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2013.04.009 ◽

2013 ◽

Vol 25 (6) ◽

pp. 459-465 ◽

Cited By ~ 32

Author(s):

Nabil Elkassabany ◽

Moustafa Ahmed ◽

S. Bruce Malkowicz ◽

Daniel F. Heitjan ◽

Joshua A. Isserman ◽

...

Keyword(s):

Radical Prostatectomy ◽

Analgesic Efficacy ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Blinded Study ◽

Retropubic Radical Prostatectomy ◽

Double Blinded

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Tramadol vs nalbuphine: analgesic efficacy and side effects. A prospective, randomized, double-blinded study in children.

European Journal of Anaesthesiology ◽

10.1097/00003643-200706001-00516 ◽

2007 ◽

Vol 24 (Supplement 39) ◽

pp. 138-139 ◽

Cited By ~ 1

Author(s):

J. Ouaki ◽

A. Rochette ◽

O. Raux ◽

Ch. Dadure ◽

X. Capdevila

Keyword(s):

Side Effects ◽

Analgesic Efficacy ◽

Blinded Study ◽

Double Blinded

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Analgesic efficacy of ultrasound-guided continuous quadratus lumborum block versus continuous paravertebral block in radical cystectomy: a randomized study

Research and Opinion in Anesthesia and Intensive Care ◽

10.4103/roaic.roaic_117_18 ◽

2021 ◽

Vol 8 (2) ◽

pp. 76

Author(s):

Mohammad HazemI Ahmad Sabry ◽

AmrR Hieba ◽

RamadanA Ammar

Keyword(s):

Radical Cystectomy ◽

Randomized Study ◽

Analgesic Efficacy ◽

Paravertebral Block ◽

Ultrasound Guided ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum

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Complication rate of ultrasound-guided paravertebral block for breast surgery

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2020-101402 ◽

2020 ◽

Vol 45 (10) ◽

pp. 813-817

Author(s):

Adam D Niesen ◽

Adam K Jacob ◽

Luke A Law ◽

Hans P Sviggum ◽

Rebecca L Johnson

Keyword(s):

Local Anesthetic ◽

Breast Surgery ◽

Vital Signs ◽

Similar Rate ◽

Paravertebral Block ◽

Block Type ◽

Ultrasound Guided ◽

Local Anesthetic Toxicity ◽

Included Patient ◽

Analgesic Technique

Background and objectivesThoracic paravertebral blockade is often used as an anesthetic and/or analgesic technique for breast surgery. With ultrasound guidance, the rate of complications is speculated to be lower than when using landmark-based techniques. This investigation aimed to quantify the incidence of pleural puncture and pneumothorax following non-continuous ultrasound-guided thoracic paravertebral blockade for breast surgery.MethodsPatients who received thoracic paravertebral blockade for breast surgery were identified by retrospective query of our institution’s electronic database over a 5-year period. Data collected included patient demographics, level of block, type and volume of local anesthetic, occurrence of pleural puncture, occurrence of pneumothorax, evidence of local anesthetic toxicity, and patient vital signs. The incidence of block complications, including pleural puncture, pneumothorax, and local anesthetic toxicity, were ascertained.Results529 patients underwent 2163 thoracic paravertebral injections. Zero pleural punctures were identified during block performance; however, two patients were found to have a pneumothorax on postoperative chest X-ray (3.6 per 1000 surgeries, 95% CI 0.5 to 13.6; 0.9 per 1000 levels blocked, 95% CI 0.1 to 3.3). There were no cases of local anesthetic systemic toxicity or associated lipid emulsion therapy administration.ConclusionsPneumothorax following non-continuous ultrasound-guided thoracic paravertebral block using a parasagittal approach is an uncommon occurrence, with a similar rate to pneumothorax following breast surgery alone.

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