• Ji Seok Baik, Ah-Young Oh, Chan Woo Cho, Hyun-Jung Shin, Sung Hee Han, and Jung Hee Ryu.
• Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea.
• Pain Med. 2014 May 1;15(5):850-6.

ObjectiveThis study evaluated whether adding a preoperative single thoracic paravertebral block (TPVB) to intravenous patient-controlled analgesia (IV PCA) would improve postoperative analgesia compared with using IV PCA alone in patients undergoing nephrectomy.DesignProspective, randomized, controlled, observer-blinded trial.SettingUniversity hospital.SubjectsThirty-four adult patients undergoing elective open nephrectomy.MethodsThe patients were randomized to receive a TPVB plus IV PCA (group T) or IV PCA alone (group C). A single 18-mL injection of 0.75% ropivacaine was administered preoperatively under ultrasound guidance; fentanyl was used for IV PCA. Each patient's postoperative pain score based on a verbal numerical rating scale, postoperative fentanyl consumption, inspiratory volume by incentive spirometry, and complications were evaluated at 1, 3, 6, 12, and 24 hours after surgery. Changes in heart rate (HR), systolic arterial pressure (SAP), and mean arterial pressure (MAP) were evaluated following skin incision.ResultsThe postoperative pain score and fentanyl consumption were significantly lower in group T than in group C at all time points up to 24 hours after surgery. The postoperative inspiratory volumes were not significantly different. The changes in HR were similar, while the increases in SAP and MAP after skin incision were lower in group T than in group C.ConclusionsA preoperative single TPVB improved postoperative analgesia by reducing the postoperative pain score and fentanyl consumption in patients undergoing nephrectomy.Wiley Periodicals, Inc.

This article appears in the collection: Paravertebral block for post-operative nephrectomy analgesia.

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