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Brief reports: paravertebral block for anesthesia: a systematic review.
Prema Thavaneswaran1, Glenda E Rudkin, Rodney D Cooter
1ASERNIP-S, Royal Australasian College of Surgeons, Adelaide, Australia.
Anesthesia and Analgesia
|May 8, 2010
Summary
Paravertebral blocks (PVBs) offer improved patient satisfaction and reduced nausea and vomiting for surgical anesthesia compared to general anesthesia (GA). While effective, PVBs carry risks like pleural puncture.
Area of Science:
- Anesthesiology
- Surgical Procedures
- Regional Anesthesia
Background:
- Paravertebral blocks (PVBs) are an alternative to general anesthesia (GA).
- Assessing the safety and efficacy of PVBs is crucial for surgical anesthesia.
- This review systematically evaluates PVBs against GA and other regional techniques.
Purpose of the Study:
- To systematically review the safety and efficacy of thoracic and lumbar paravertebral blocks (PVBs) for surgical anesthesia.
- To compare PVBs with general anesthesia (GA) and other regional anesthetic techniques.
Main Methods:
- Systematic review of peer-reviewed literature.
- Searched MEDLINE, EMBASE, and The Cochrane Library up to May 2008.
- Included eight randomized controlled trials (RCTs) for breast surgery and herniorrhaphy.
Main Results:
- PVB failure rate was below 13%.
- Patients reported higher satisfaction with PVBs compared to GA.
- PVBs significantly reduced postoperative nausea and vomiting (RR 0.25, 95% CI: 0.13-0.50).
- Potential for shorter hospital stays with PVBs was indicated.
- Risks include pleural puncture and local anesthetic epidural spread.
Conclusions:
- PVBs provide less postoperative pain and nausea/vomiting than GA.
- PVBs are associated with greater patient satisfaction compared to GA.
- Current evidence supports PVBs for thoracic and lumbar surgical anesthesia.
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