title: Analgesia in post-thoracotomy patients: Comparison between thoracic epidural and thoracic paravertebral blocks.
abstract: BACKGROUND
  Acute postoperative pain can cause detrimental effects on multiple organ systems, leading to chronic pain syndromes.
  
  
  OBJECTIVE
  To compare thoracic epidural block (TEB) and paravertebral block (PVB) for relief of postoperative pain in adult patients undergoing thoracotomy.
  
  
  METHODS
  In this randomized, single-blinded, prospective study, 60 adult patients of both sexes, belonging to ASA physical status I and II, were scheduled for elective thoracotomy under general anesthesia. They were randomly divided into two groups, A and B of 30 each, who were comparable in terms of demographic parameters and body weight. Group A received TEB and Group B received PVB. All the patients underwent thoracotomy under general anesthesia using a uniform standard anesthetic technique. Thirty minutes before the anticipated end of skin suture, blocks were activated in both the groups with 7.5 ml for TEB and 15 ml for thoracic PVB of 0.25% bupivacaine, along with 1 ml of fentanyl for postoperative analgesia.
  
  
  RESULTS
  Patients receiving PVB for postoperative analgesia experienced better analgesia than those receiving TEB from the immediate postoperative period that lasted longer. Intragroup comparison showed that in the cases receiving TEB, there was a significant statistical difference in preoperative and postoperative values with regard to the mean systolic blood pressure (SBP), mean arterial pressure and mean pulse rate. However, in patients receiving PVB, significant difference in preoperative and postoperative values was seen in mean SBP only.
  
  
  CONCLUSIONS
  We observed longer duration of analgesia with PVB compared to TEB.
authors.affiliation: Department of Anaesthesiology, College of Medicine and JNM Hospital, Kalyani, West Bengal, India.
authors.forename: Maitreyee
authors.initials: M
authors.lastname: Mukherjee
authors.affiliation: Institute of Postgraduate Medical Education & Research, Kolkata, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Goswami
authors.affiliation: Institute of Postgraduate Medical Education & Research, Kolkata, India.
authors.forename: Sampa Dutta
authors.initials: SD
authors.lastname: Gupta
authors.affiliation: Burdwan Medical College, Burdwan, West Bengal, India.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Sarbapalli
authors.affiliation: Department of Community Medicine, Sikkim Manipal Institute of Medical Sciences (SMIMS) and Central Referral Hospital (CRH), 5th Mile, Tadong, Gangtok, Sikkim - 737 102, India.
authors.forename: Ranabir
authors.initials: R
authors.lastname: Pal
authors.affiliation: Department of Community Medicine, Sikkim Manipal Institute of Medical Sciences (SMIMS) and Central Referral Hospital (CRH), 5th Mile, Tadong, Gangtok, Sikkim - 737 102, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Kar
keywords: Analgesia; paravertebral block; thoracic epidural block