title: Single-dose, bilateral paravertebral block plus intravenous sufentanil analgesia in patients with esophageal cancer undergoing combined thoracoscopic-laparoscopic esophagectomy: a safe and effective alternative.
abstract: OBJECTIVE
  Paravertebral block (PVB) has been shown to be an ideal aid for analgesia after thoracic or abdominal surgery. The authors studied the safety and efficacy of the single-dose and bilateral ultrasound-guided (USG)-PVB before combined thoracoscopic-laparoscopic esophagectomy (TLE) along with intravenous sufentanil analgesia as a method of pain relief in comparison with intravenous sufentanil as a sole analgesic agent.
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Single university hospital.
  
  
  METHODS
  Fifty-two patients undergoing TLE.
  
  
  METHODS
  A USG-PVB was performed before surgery using a solution of 30 mL of 0.5% ropivacaine by 3 injections of 10 mL each at the right T5 and bilateral T8 (PVB group, n=26) or the saline injection of 10 mL at every site (control group, n=26).
  
  
  RESULTS
  Successful PVBs were achieved in all patients of the PVB group. Intraoperative mean remifentanil usage and end-tidal sevoflurane concentration were lower in the PVB group (p<0.001). Hemodynamic parameters were stable in both groups. Postoperative pain scores both at rest and on coughing were lower during the first 8 hours in the PVB group than those in the control group (p<0.05). Cumulative sufentanil consumption delivered by patient-controlled analgesia (PCA) was significantly lower in the PVB group at all time points (p<0.05). Postoperative pulmonary function was better at the third postoperative day in the PVB group (p<0.05), with quicker hospital discharge and lower hospital costs (p<0.05).
  
  
  CONCLUSIONS
  The single-dose and bilateral PVB given before TLE combined with sufentanil may provide better postoperative analgesia and early discharge in patients undergoing TLE.
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China. Electronic address: doctor_fc@163.com.
authors.forename: Cai
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
authors.forename: Qing-Tian
authors.initials: QT
authors.lastname: Geng
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
authors.forename: Song
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
authors.forename: Fang
authors.initials: F
authors.lastname: Kang
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
authors.forename: Jian-Hui
authors.initials: JH
authors.lastname: Pan
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
authors.forename: Xiao-Qing
authors.initials: XQ
authors.lastname: Chai
authors.affiliation: Department of Anesthesiology, Anhui Medical University Affiliated Auhui Provincial Hospital, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wei
mesh_terms: D016058:Analgesia, Patient-Controlled / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000628:therapy; D011446:Prospective Studies; D017409:Sufentanil / Q000008:administration & dosage*; D013900:Thoracic Nerves; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D017409:Sufentanil
keywords: analgesia; combined thoracoscopic-laparoscopic esophagectomy; paravertebral block; postoperative pain