[Paravertebral block for open cholecystectomy]

Open cholecystectomy is usually performed under general anaesthesia; the use of regional techniques is limited to those patients in whom general anaesthesia poses a certain risk and should be avoided. Among other techniques, paravertebral block can be used for perioperative analgesia. We evaluated the efficacy of thoracic paravertebral block (TPVB) for this purpose.

The local Ethical Committee approved the study. Sixty consecutive ASA I-II patients were randomly allocated to two groups. Patients in group K received standard opioid general anaesthesia while patients in group B had a TPVB performed before the induction of general anaesthesia. In addition to demographic data and patient satisfaction, the following information was collected during the first three days after surgery: main haemodynamic parameters, the number of complications, the intensity of pain, rated using the Numerical Pain Rating Scale, and the frequency of postoperative nausea and vomiting (PONV).

During the first 72 h after surgery, the mean pain score was significantly lower in patients of group B (p<0.005). PONV were more frequent in group K (60% vs 33%, p=ns) and were observed earlier (p=0.0007). Patient satisfaction was higher in group II.

General anaesthesia with unilateral thoracic paravertebral block provides satisfactory conditions for open cholecystectomy. TPVB significantly improved the quality of postoperative analgesia, reduced the frequency of PONV, and increased the comfort of patients.