Ultrasound-guided Thoracic Paravertebral Block Using Ropivacaine With/Without Dexamethasone in Elective Thoracotomy
Status:
Completed
Trial end date:
2017-01-20
Target enrollment:
Participant gender:
Summary
The procedures of thoracotomy are among the most painful operations. In addition to
post-thoracotomy pain, the outcomes of surgery are affected adversely by postoperative
discomfort. Therefore, post-thoracotomy pain control can improve the satisfaction of patient
and prevent postoperative complications such as pneumonia, atelectasis, or respiratory
failure. Thoracic epidural analgesia (TEA) used to be widely considered as a standard
technique for providing analgesia after a thoracotomy. However, TEA carries side-effects such
as incomplete or failed block, epidural hematoma, abscess, hypotension, respiratory
depression, or bradycardia, etc. Recently, thoracic paravertebral block (TPVB) is an
alternative technique for TEA that may offer a comparable analgesic effect and a better side
-effect profile for post-thoracotomy analgesia. When local anesthetic agents are used as
single injection, they can provide analgesia for limited period. Various adjuvants have been
tried in the past in order to enhance the duration and quality of postoperative analgesia.
Previous studies with perineural dexamethasone demonstrated that it enhanced the duration of
local anesthetic block. The mechanism of its action is blocking the nociceptive impulse
transmission along the myelinated C fibers. Patient-controlled analgesia (PCA) devices have
been shown to provide superior analgesia and greater patient satisfaction compared with
intermittent administration. System of wire-less PCA provides remote monitoring, information
management and PCA devices with high precision. The purpose of this research is to determine
whether dexamethasone might prolong the duration of analgesia and improve the short-time
outcomes when administered for TPVB along with local anesthetic agents in elective
thoracotomy.
Phase:
N/A
Details
Lead Sponsor:
The First Affiliated Hospital of Anhui Medical University