Assessment of postoperative pain management and comparison of effectiveness of pain relief treatment involving paravertebral block and thoracic epidural analgesia in patients undergoing posterolateral thoracotomy

Małgorzata Edyta Wojtyś, Józef Wąsikowski, Norbert Wójcik, Janusz Wójcik, Piotr Wasilewski, Piotr Lisowski, Tomasz Grodzki, Małgorzata Edyta Wojtyś, Józef Wąsikowski, Norbert Wójcik, Janusz Wójcik, Piotr Wasilewski, Piotr Lisowski, Tomasz Grodzki

Abstract

Background: TEA (thoracic epidural analgesia) is considered a basic method of analgesia used in thoracic surgeries. PVB (paravertebral block) is an alternative method. The thesis compares effectiveness of both methods in postoperative analgesia with particular focus on assessment of the postoperative pain management quality.

Methods: The study involved 2 groups of patients, each consisting of 30 patients undergoing posterolateral thoracotomy. The study group involved patients anesthetized applying PVB method, while the control group involved patients anesthetized with TEA. Hemodynamic and respiratory parameters as well as severity of pain assessed using NRS (numeric rating scale) during the first 3 days after the surgery, number of days of hospitalization, and the need to use additional pain relievers were taken into account in both groups. Evaluation of postoperative pain management quality was performed applying Clinical Quality Indicators in Postoperative Pain Management.

Results: No statistical significance was demonstrated between the groups in respect of hemodynamic and respiratory parameters values, the need to use additional pain relievers and the number of days of hospitalization. There was no statistically significant difference between the groups in respect of general assessment of pain management quality, except for the assessment of the lowest level of pain within the last 24 h of measurement. This result in TEA group was statistically significantly lower than the one in PVB group (p = 0.019).

Conclusions: In the assessment of postoperative pain management quality both analyzed methods are statistically significantly different only in the category of "lowest level of pain within the last 24 hours of measurement", to the benefit of TEA group. No statistically significant difference has been observed between the two study groups with respect to the remaining parameters.

Trial registration: KB-0012/71/15. Date of registration 22 June 2015.

Keywords: Assessment of pain management quality; Epidural analgesia; Paravertebral block; Posterolateral thoracotomy; Regional analgesia.

Conflict of interest statement

Ethics approval and consent to participate

Ethics Committee of the Pomeranian Medical University in Szczecin approved the study conduct (KB-0012/71/15).

Consent for publication

not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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