title: Preemptive ultrasound-guided paravertebral block and immediate postoperative lung function.
abstract: OBJECTIVE
  The aim of this study was to investigate the effects of preemptive ultrasound-guided thoracic paravertebral block versus intercostal block on postoperative respiratory function and pain control in patients undergoing video-assisted thoracoscopic surgery.
  
  
  METHODS
  50 consecutive patients undergoing video-assisted thoracoscopic surgery.
  
  
  METHODS
  A prospective cohort of patients who received either ultrasound-guided thoracic paravertebral block immediately before the procedure or intercostal block placed by the surgeon at the end of the procedure were studied. Pulmonary function was assessed before surgery and 4 h postoperatively. Pain was assessed with the visual analog scale at 2 and 4 h after surgery both at rest and on coughing.
  
  
  RESULTS
  30 patients on the paravertebral block group and 20 on the intercostal block group were studied. Forced vital capacity (p < 0.001), forced expiratory volume at 1 s (p < 0.001) and forced expiratory flow 25-75% (p = 0.001) were significantly higher at 4 h with paravertebral block compared to the intercostal block group. The visual analog score for pain was significantly improved with paravertebral block at rest (p < 0.05) and with cough (p = 0.00). Perioperative narcotic use was significantly reduced with paravertebral block in comparison to intercostal block (p = 0.04).
  
  
  CONCLUSIONS
  When compared to intercostal blocks, ultrasound-guided thoracic paravertebral block appears to preserve lung function and provide better pain control in the immediate postoperative period after video-assisted thoracoscopic surgery.
authors: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
authors: Robina
authors: R
authors: Matyal
authors: Mario
authors: M
authors: Montealegre-Gallegos
authors: Marc
authors: M
authors: Shnider
authors: Khurram
authors: K
authors: Owais
authors: Sruthi
authors: S
authors: Sakamuri
authors: Omair
authors: O
authors: Shakil
authors: Vipul
authors: V
authors: Shah
authors: John
authors: J
authors: Pawlowski
authors: Sidharta
authors: S
authors: Gangadharan
authors: Phillip
authors: P
authors: Hess
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D018084:Ultrasonography, Interventional
chemical_list: D000700:Analgesics