• Hyo-Seok Na, Chang-Hoon Koo, Bon-Wook Koo, Jung-Hee Ryu, Hayoung Jo, and Hyun-Jung Shin.
• Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea; Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
• J. Cardiothorac. Vasc. Anesth. 2023 Feb 1; 37 (2): 252260252-260.

ObjectiveThis study aimed to identify the benefits of thoracic paravertebral block (PVB) by focusing on its role in reducing chronic postsurgical pain (CPSP) after thoracic surgery.DesignA systematic review and meta-analysis of randomized controlled trials (RCTs).SettingElectronic databases, including PubMed, EMBASE, CENTRAL, Scopus, and Web of Science, were searched to identify studies.ParticipantsPatients undergoing thoracic surgeries.InterventionParavertebral block for postoperative analgesia.Measurement And Main ResultsA total of 1,028 adult patients from 10 RCTs were included in the final analysis. The incidence of CPSP at 3 months after surgery was not reduced in the PVB group compared with the no-block (odds ratio [OR] 0.59, 95% CI 0.34-1.04; p = 0.07; I2 = 6.96%) and other-block (OR 1.39, 95% CI 0.30-6.42; p = 0.67; I2 = 77.75%) groups. The PVB did not significantly reduce the incidence of CPSP after 6 months from surgery when compared with no block (OR 0.44, 95% CI 0.08-2.53; p = 0.36; I2 = 87.53%) and other blocks (OR 1.17, 95% CI 0.71-1.95; p = 0.93; I2 = 45.75%). The PVB significantly decreased postoperative pain at 24 and 48 hours at rest compared with the no- block group. The pain score was higher in the PVB group than in the other block groups 48 hours after surgery at rest.ConclusionsThoracic PVB does not prevent CPSP after thoracic surgery. Further large RCTs are required to confirm and validate the authors' results.Copyright © 2022 Elsevier Inc. All rights reserved.

17 keywords...

hide…