Comparison of Thoracic Epidural and Paravertebral Block for Postoperative Pain Control in Patients with Thoracotomy

Abstract

Objective: To compare post-operative analgesic effect and complications of thoracic epidural and paravertebral block in thoracotomy patients.

Study Design: Randomized clinical trial study

Place and Duration of Study: This study was conducted at the Lady Reading Hospital in Peshawar from November 2022 to October 2023.

Methods: Overall, 380 patients were included in this study both genders. Patients were divided into two groups (TPVB and TEA) by lottery method. There were 306 patients received TPVB and 74 patients received TEA. Both groups, TEB or PVB as applicable, had their respective interventions applied 30 minutes before end of surgery, with the time duly recorded.

Results: VAS score at 1 hour of thoracotomy was 3.96 ± 1.13 in TPVB group and 4.16 ± 1.22 in TEA group, at 2 hours it was 3.54±0.81 and 3.44±1.21, at 6 hours 3.08±0.93 and 3.09±0.98, at 12 hours 2.46±0.66 and 2.41±0.69, at 24 hours it was 1.97±0.28 and 1.98±0.31 in TPBV and TEA group, respectively.

Conclusion: Management of postoperative pain in thoracotomy patients, it was noted that preemptive thoracic paravertebral block (TPVB) and thoracic epidural analgesia (TEA) resulted in similar Visual Analog Scale (VAS) scores and supplemental analgesic requirements.