title: Paravertebral block provides significant opioid sparing after hand-assisted laparoscopic nephrectomy: an expanded case report of 30 patients.
abstract: OBJECTIVE
  We report our experience of paravertebral block (PVB) on analgesic requirements and dynamic pain in patients presenting for hand-assisted laparoscopic nephrectomy (HALN) and compare our results with conventional opioid therapy.
  
  
  METHODS
  From October 2006 to May 2008, 30 patients (male:female ratio, 17:13) scheduled for HALN received paravertebral analgesia preoperatively. Postoperative opioid requirements and dynamic visual analog scale pain scores were determined in the recovery room and every 8 hours for 48 hours postoperatively. Data were obtained from medical records and patient interview.
  
  
  RESULTS
  The paravertebral analgesia was completed in all 30 patients with a mean visual analog scale score of 3.08 (0-10). Cumulative morphine equivalent doses were 11.82 mg (0-41 mg), whereas in two other studies, it ranged from 24 to 54 mg.
  
  
  CONCLUSIONS
  PVBs provided excellent analgesia with significant opioid sparing in this pilot series of 30 patients with HALN. Utilization of multimodal analgesia incorporating PVB is recommended for patients presenting for HALN.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida 32224, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Clendenen
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wehle
authors.forename: Gabriel A
authors.initials: GA
authors.lastname: Rodriguez
authors.forename: Roy A
authors.initials: RA
authors.lastname: Greengrass
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000494:pharmacology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011182:Postoperative Care
chemical_list: D000701:Analgesics, Opioid