Comparative Evaluation of Continuous Thoracic Paravertebral Block and Thoracic Epidural Analgesia Techniques for Post–operative Pain Relief in Patients Undergoing Open Cholecystectomy: A Prospective, Randomized, Single Blind Study

Dr Sujeet Gautam; Dr Abhishek Keshari; Dr Pravin Kumar Das

Volume : VII, Issue : VII, July - 2017

Comparative Evaluation of Continuous Thoracic Paravertebral Block and Thoracic Epidural Analgesia Techniques for Post–operative Pain Relief in Patients Undergoing Open Cholecystectomy: A Prospective, Randomized, Single Blind Study

Dr Sujeet Gautam, Dr Abhishek Keshari, Dr Pravin Kumar Das

Abstract :

Background: The aim of this prospective, randomized, single blind study was to compare the efficacy of post–operative pain relief provided by continuous thoracic paraverteal block with continuous thoracic epidural analgesia in patients undergoing open cholecystectomy.

Methods: Sixty four adult patients undergoing open cholecystectomy under general anaesthesia were randomized into two groups; Group EA patients received intra–operative and post–operative epidural infusion of a solution containing 0.1% bupivacaine with 1 μg ml^–1 fentanyl at 7ml hr^–1; Group PVA patients received intra–operative and post–operative paraverteal infusion of a solution containing 0.1% bupivacaine with 1 μg ml^–1 fentanyl at 7ml hr^–1. Primary outcome measures were postoperative pain during rest (lying supine), deep inspiration, coughing and movement (getting up from supine to sitting position); secondary outcome measures were post–operative fentanyl consumption, post–operative nausea and vomiting (PONV), requirement of rescue antiemetic, hypotension, sedation, pruritus, motor block and respiratory depression; these were assessed at 6 hourly intervals for a period of 48 hrs in the post–operative period.

Results: The two groups were similar with regard to demographic factors (P>0.05). The VAS scores during rest, deep eathing, coughing and movement (getting up from supine to sitting position) and postoperative fentanyl consumption were similar in the paraverteal and epidural analgesia groups (P>0.05); the incidence of side effects were also similar in the two groups (P>0.05).

Conclusions: We observed that continuous thoracic paraverterbal analgesia provides post–operative analgesia as effective as continuous thoracic epidural analgesia in patients undergoing open cholecystectomy.

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