Prospective randomized trial of bilateral paravertebral block versus thoracic epidural analgesia for off-pump coronary artery bypass (OPCAB) surgery

Dr Sanjeeta Umbarkar; Dr Pushkar Desai; Dr Ashish Varma

Volume : VII, Issue : VII, July - 2018

Prospective randomized trial of bilateral paravertebral block versus thoracic epidural analgesia for off-pump coronary artery bypass (OPCAB) surgery

Dr Sanjeeta Umbarkar, Dr Pushkar Desai, Dr Ashish Varma

Abstract :

Adequate analgesia after OPCAB prevents postoperative pulmonary complications. This study compared the efficacy of continuous thoracic epidural (TEA) versus paraverteal block (PVB) with regard to quality of analgesia and complications in sixty patients undergoing elective OPCAB.Group A received thoracic epidural at T3–T4/ T4–T5 while in group B, bilateral paraverteal spaces were catheterized at T3–T4 level. Inj Ropivacaine0.2% + Fentanyl 2 mcg/ml@5–7ml/hr was started in both groups and continued till 24 hours after surgery. Pain score was assessed using visual analogue scale (VAS) at rest and while coughing at extubation, 6, 12 and 24 hours. VAS scores were similar but rescue analgesia requirement was higher in group A (23.3% vs 13.3%; p=0.51). Duration of mechanical ventilation, opioids and muscle relaxant requirement and hospital stay were similar. Conclusion: Bilateral paraverteal block is a safe and effective technique during OPCAB.