• J. Cardiothorac. Vasc. Anesth. · Feb 2022

    Efficacy of Preoperative Bilateral Thoracic Paravertebral Block in Cardiac Surgery Requiring Full Heparinization: A Propensity-Matched Study.

    • Masaaki Naganuma, Takaharu Tokita, Yuri Sato, Toshinori Kasai, Yasushi Kudo, Nobuaki Suzuki, Shinya Masuda, and Koichi Nagaya.
    • Department of Cardiovascular Surgery, Aomori Prefectural Central Hospital, Aomori, Japan. Electronic address: naganuma0110@hotmail.co.jp.
    • J. Cardiothorac. Vasc. Anesth. 2022 Feb 1; 36 (2): 477-482.

    ObjectivesTo assess the efficacy of preoperative bilateral paravertebral block (PVB) with general anesthesia (GA) in contributing to early extubation and decreasing opioid consumption in cardiac surgery.DesignA propensity score-matched retrospective study.SettingA single tertiary medical center between January 2018 and December 2020.ParticipantsAdult patients undergoing isolated first-time aortic valve replacement and coronary artery bypass grafting with full sternotomy.InterventionsA cohort of 44 patients who received PVB with GA (PVB group) was matched with 44 patients who underwent similar surgery with GA only (GA only group).Measurements And Main ResultsThe completion rate of extubation in the operating room was significantly greater in the PVB group (65.9%) than in the GA only group (43.2%; p = 0.032). The completion rate of extubation within eight hours after surgery also was significantly greater in the PVB group (86.4%) than in the GA only group (68.2%; p = 0.042). The median amount of intraoperative fentanyl administered was significantly less in the PVB group (4.8 µg/kg; interquartile range [IQR], 3.3-7.2) than in the GA only group (8.4 µg/kg; IQR, 5.4-12.7; p < 0.001). The median amount of postoperative fentanyl administered was significantly less in the PVB group (6.8 µg/kg; IQR, 3.9-10.6) than in the GA only group (8.1 µg/kg; IQR, 6.2-15.9; p = 0.012).ConclusionsThis study demonstrated that preoperative bilateral PVB combined with GA contributed to early extubation in isolated first-time aortic valve replacement and coronary artery bypass grafting and in the reduction of intraoperative and postoperative fentanyl consumption.Copyright © 2021 Elsevier Inc. All rights reserved.

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