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

    Randomized Controlled Trial

    Single-Injection Midpoint Transverse Process-to- Pleura Block Versus Thoracic Paravertebral Block for Postoperative Analgesia After Uniportal Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Trial.

    • Xu Chen, Jinjing Yang, Min Xia, Hao Wu, Sheng Wang, and Wei Zhang.
    • Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
    • J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt A): 2432-2438.

    ObjectivesThe effect of midpoint transverse process-to-pleura block (MTPB) is unclear. The authors compared the analgesic characteristics of MTPB with those of thoracic paravertebral nerve block (TPVB) in patients undergoing uniportal video-assisted thoracoscopic surgery (uVATS) and examined the 2 types of blocks for noninferiority.DesignA randomized, controlled trial.SettingA single-institution, university hospital.ParticipantsThe study comprised 82 patients between 18 and 75 years of age. Eighty-one patients were included for final analysis.InterventionsPatients were randomly allocated to either the MTPB group (Group M) or the TPVB group (Group P).Measurements And Main ResultsThe primary outcome was the mean difference in the postoperative visual analog scale (VAS) score between Group M and Group P at rest and at 12 hours. The secondary outcomes included VAS scores during rest and coughing, nerve block performance, intraoperative consumption of anesthetics and vasoactive medication, time at first use of patient-controlled intravenous analgesia (PCIA), number of uses of PCIA, consumption of sufentanil in PCIA, and side effects. The mean difference in VAS score in the MTPB and TPVB group at rest and 12 hours postoperatively was 0.5 (95% confidence interval, -0.26 to 0.36). There was no significant difference in the time at first use of PCIA, which was 12 (10, 12) hours and 11 (10, 12) hours in Group M and Group P, respectively. The depth of puncture was shallower, and the time to perform block was shorter in Group M compared with Group P (p < 0.001).ConclusionsThe analgesic effect of single-level-injection MTPB is noninferior to that of TPVB in patients undergoing uVATS. The target point of the needle in MTPB is shallower and farther away from the pleura compared with TPVB. For these reasons, it is quicker and safer and, thus, may be preferable.Copyright © 2022 Elsevier Inc. All rights reserved.

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