Medical science monitor : international medical journal of experimental and clinical research
-
BACKGROUND Regional anesthesia provides excellent analgesic effects after surgery. However, the effects of regional anesthesia on nociceptive levels during surgery under general anesthesia have not been quantitatively evaluated. To reveal the effects of thoracic paravertebral block (PVB) on nociceptive levels after skin incision during general anesthesia, we performed a retrospective cohort study in patients without serious preoperative conditions or comorbidities undergoing elective video-assisted thoracoscopic surgery (VATS). ⋯ Mean NR values at T1 and T2 in the PVB group were significantly lower than those in the Control group. SBP, HR, PI, and BIS, however, showed no significant differences between the 2 groups, except for SBP at T2. CONCLUSIONS Thoracic PVB prevented an increase in NR values, which quantitatively represent nociceptive levels under general anesthesia, in patients undergoing VATS.
-
Meta Analysis Comparative Study
Combining Spinal-Epidural Anesthesia versus Single-Shot Spinal Anesthesia for Cesarean Delivery: A Meta-Analysis of 5 Randomized Controlled Trials.
BACKGROUND This study compared combined spinal-epidural anesthesia (CSEA) and single-shot spinal anesthesia (SSSA) by performing a meta-analysis. MATERIAL AND METHODS An electronic search of relevant studies was done through 2017. Primary endpoints included duration of surgery, and time for (1) sensory recovery to thoracic vertebra (T10), (2) maximal sensory, (3) motor blockade, and (4) motor recovery. ⋯ Adverse effects such as hypotension (OR: 1.49, 95%CI: 0.27-8.31), pruritus (OR: 0.23, 95%CI: 0.03-2.18), nausea/vomiting (OR: 0.84, 95%CI: 0.12-5.99). and shivering (OR: 0.53, 95%CI: 0.11-2.56) were also similar with CSEA and SSSA. CONCLUSIONS CSEA was not associated with significantly different maximal duration of sensory/motor blockade, complete motor recovery, sensory regression to T10, or adverse drug events compared to SSSA. Hence, both should be considered effective in cesarean delivery.