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Lapkina I.V.

I.M. Sechenov First Moscow State Medical University

Alekseeva T.M.

I.M. Sechenov First Moscow State Medical University

Khalikova E.Yu.

I.M. Sechenov First Moscow State Medical University

Ali S.Kh.

I.M. Sechenov First Moscow State Medical University

Sukhanov R.B.

I.M. Sechenov First Moscow State Medical University

Slusarenko R.I.

I.M. Sechenov First Moscow State Medical University

Bezrukov E.A.

I.M. Sechenov First Moscow State Medical University

Paravertebral block in fast track urology

Authors:

Lapkina I.V., Alekseeva T.M., Khalikova E.Yu., Ali S.Kh., Sukhanov R.B., Slusarenko R.I., Bezrukov E.A.

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Journal: Russian Journal of Anesthesiology and Reanimatology. 2020;(4): 87‑92

DOI: 10.17116/anaesthesiology202004187

Views: 3183

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To cite this article:

Lapkina IV, Alekseeva TM, Khalikova EYu, Ali SKh, Sukhanov RB, Slusarenko RI, Bezrukov EA. Paravertebral block in fast track urology. Russian Journal of Anesthesiology and Reanimatology. 2020;(4):87‑92. (In Russ.)
https://doi.org/10.17116/anaesthesiology202004187

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OBJECTIVE

To compare an effectiveness of general anesthesia (GA) combined with paravertebral block (GA+PVB), general anesthesia combined with epidural anesthesia (GA+EA) and general anesthesia (GA) in a urological hospital.

MATERIAL AND METHODS

All patients (n=182) were divided into 3 groups depending on the type of anesthetic management: GA+PVB, GA, GA+EA. An amount of opioid analgesic was intraoperatively assessed. Effectiveness of analgesia with a visual analogue scale (VAS), early activation, incidence of hemodynamic impairment and motor block were analyzed in postoperative period.

RESULTS

VAS scores were significantly lower in the GA+PVB group compared to the GA group in 1, 6 and 24 hours after surgery (p=0.015). VAS scores were similar in the GA+PVB and GA+EA groups within 6 and 12 hours after surgery. Intraoperative doses of opioid analgesic (Fentanyl) were lower in the GA+PVB group compared to all other patients (p<0.001). It should be noted that doses of narcotic analgesic were similar for GA+EA and GA (p=0.467). GA+PVB was not followed by postoperative motor block. In the GA+EA group, this event occurred in 30% of patients. No motor block and hemodynamic impairment after PVB ensured early activation of all patients in the GA+PVB group.

CONCLUSION

Paravertebral block is a simple, effective and safe technique for perioperative analgesia in urological patients, including fast track surgical approach. No motor block and hemodynamic instability determines an obvious advantage of paravertebral block over epidural anesthesia.

Keywords:

paravertebral block
epidural anesthesia
fast track surgery
visual analogue scale
fast track recovery

Authors:

Lapkina I.V.

I.M. Sechenov First Moscow State Medical University

Alekseeva T.M.

I.M. Sechenov First Moscow State Medical University

Khalikova E.Yu.

I.M. Sechenov First Moscow State Medical University

Ali S.Kh.

I.M. Sechenov First Moscow State Medical University

Sukhanov R.B.

I.M. Sechenov First Moscow State Medical University

Slusarenko R.I.

I.M. Sechenov First Moscow State Medical University

Bezrukov E.A.

I.M. Sechenov First Moscow State Medical University

Received:

18.05.2020

Accepted:

20.06.2020

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