Effect of the Paravertebral Block on Chronic Postsurgical Pain After Thoracic Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

被引:7
作者
Na, Hyo-Seok [1 ,2 ]
Koo, Chang-Hoon [1 ,2 ]
Koo, Bon-Wook [1 ,2 ]
Ryu, Jung-Hee [1 ,2 ]
Jo, Hayoung [1 ]
Shin, Hyun-Jung [1 ,2 ]
机构
[1] Seoul Natl Univ, Dept Anesthesiol & Pain Med, Bundang Hosp, 82 Gumi Ro 173 Beon Gil, Seongnam 13620, Gyeonggi, South Korea
[2] Seoul Natl Univ, Dept Anesthesiol & Pain Med, Coll Med, Seoul, South Korea
关键词
paravertebral block; thoracic surgery; chronic postsurgical pain; postoperative analgesia; pain; POSTTHORACOTOMY PAIN; POSTOPERATIVE ANALGESIA; REGIONAL ANALGESIA; MANAGEMENT; THORACOTOMY;
D O I
10.1053/j.jvca.2022.10.029
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Objective: This study aimed to identify the benefits of thoracic paravertebral block (PVB) by focusing on its role in reducing chronic postsurgi-cal pain (CPSP) after thoracic surgery. Design: A systematic review and meta-analysis of randomized controlled trials (RCTs). Setting: Electronic databases, including PubMed, EMBASE, CENTRAL, Scopus, and Web of Science, were searched to identify studies. Participants: Patients undergoing thoracic surgeries. Intervention: Paravertebral block for postoperative analgesia. Measurement and Main Results: A total of 1,028 adult patients from 10 RCTs were included in the final analysis. The incidence of CPSP at 3 months after surgery was not reduced in the PVB group compared with the no-block (odds ratio [OR] 0.59, 95% CI 0.34-1.04; p = 0.07; I2 = 6.96%) and other-block (OR 1.39, 95% CI 0.30-6.42; p = 0.67; I2 = 77.75%) groups. The PVB did not significantly reduce the incidence of CPSP after 6 months from surgery when compared with no block (OR 0.44, 95% CI 0.08-2.53; p = 0.36; I2 = 87.53%) and other blocks (OR 1.17, 95% CI 0.71-1.95; p = 0.93; I2 = 45.75%). The PVB significantly decreased postoperative pain at 24 and 48 hours at rest compared with the no-block group. The pain score was higher in the PVB group than in the other block groups 48 hours after surgery at rest. Conclusions: Thoracic PVB does not prevent CPSP after thoracic surgery. Further large RCTs are required to confirm and validate the authors' results.(c) 2022 Elsevier Inc. All rights reserved.
引用
收藏
页码:252 / 260
页数:9
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