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Research article
Shaoqi He
Third affiliated Hospital of Wenzhou Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9368-2228
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Kyphoplasty for osteoporotic vertebral compression fractures was short but painful especially during trocar insertion, balloon dilatation and cement injection. Different anesthetic techniques have been proposed to control pain during kyphoplasty, but all have limitations. The purpose of the current study was to investigate the effects and safety of ultrasound-guided thoracic paravertebral block in patients undergoing percutaneous kyphoplasty (PKP).
Methods: A prospective study of 195 patients with thoracic compression fracture undergoing PKK was conducted. The patients were non-randomly assigned to receive an ultrasound-guided thoracic paravertebral block (Group P, n=96) and local infiltration anesthesia (Group L, n=99), and were compared along with anesthesia time, operation time, blood loss, hospitalization time, costs, complications, additional analgesia rate, investigators’ satisfaction scores, patients’ anesthesia satisfaction scores and intention rate of re-administration anesthesia. Visual analog scale (VAS) of pain, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured at pre-anesthesia (T0), post-anesthesia (T1), trocar insertion (T2), balloon dilatation (T3), cement injection (T4) and post-operation (T5).
Results: The anesthesia time was significantly longer in group P than in group L (23.73±4.20 min vs. 6.31±2.14 min, P <0.05). There were no significant differences in the epidemiological data, operation time, blood loss, hospitalization time complications and costs between the two groups. The additional analgesics rate was significantly lower in group P than in group L (6.25% vs. 23.23%, P <0.05). The investigators’ satisfaction scores [4 (3-5) vs. 3(2-4), P <0.05], patients’ anesthesia satisfaction scores [2 (2-3) vs. 2 (1-3), P <0.05] and intention rate of re-administration anesthesia (90.63% vs. 69.70%, P <0.05) were significantly higher in group P than in group L. Intraoperative VAS score (T1-T4) was significantly lower in group P than in group L (2 (1-3) vs. 3 (2-4), 2 (2-3) vs. 4 (2-4), 2 (2-3) vs. 5 (3-5), 3 (2-3) vs. 5 (3-5), P <0.05). There was no significant difference in VAS scores (T0 and T5), SBP, DBP and HR between these two groups.
Conclusion: Ultrasound - guided thoracic paravertebral block achieved more effective analgesia in comparison to local infiltration groups in patients undergoing percutaneous kyphoplasty.
Keywords
Thoracic paravertebral block, ultrasound guided, local infiltration, osteoporotic vertebral compression fracture, percutaneous kyphoplasty
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Shaoqi He
Third affiliated Hospital of Wenzhou Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9368-2228
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 11 Nov, 2019
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Kyphoplasty for osteoporotic vertebral compression fractures was short but painful especially during trocar insertion, balloon dilatation and cement injection. Different anesthetic techniques have been proposed to control pain during kyphoplasty, but all have limitations. The purpose of the current study was to investigate the effects and safety of ultrasound-guided thoracic paravertebral block in patients undergoing percutaneous kyphoplasty (PKP).
Methods: A prospective study of 195 patients with thoracic compression fracture undergoing PKK was conducted. The patients were non-randomly assigned to receive an ultrasound-guided thoracic paravertebral block (Group P, n=96) and local infiltration anesthesia (Group L, n=99), and were compared along with anesthesia time, operation time, blood loss, hospitalization time, costs, complications, additional analgesia rate, investigators’ satisfaction scores, patients’ anesthesia satisfaction scores and intention rate of re-administration anesthesia. Visual analog scale (VAS) of pain, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured at pre-anesthesia (T0), post-anesthesia (T1), trocar insertion (T2), balloon dilatation (T3), cement injection (T4) and post-operation (T5).
Results: The anesthesia time was significantly longer in group P than in group L (23.73±4.20 min vs. 6.31±2.14 min, P <0.05). There were no significant differences in the epidemiological data, operation time, blood loss, hospitalization time complications and costs between the two groups. The additional analgesics rate was significantly lower in group P than in group L (6.25% vs. 23.23%, P <0.05). The investigators’ satisfaction scores [4 (3-5) vs. 3(2-4), P <0.05], patients’ anesthesia satisfaction scores [2 (2-3) vs. 2 (1-3), P <0.05] and intention rate of re-administration anesthesia (90.63% vs. 69.70%, P <0.05) were significantly higher in group P than in group L. Intraoperative VAS score (T1-T4) was significantly lower in group P than in group L (2 (1-3) vs. 3 (2-4), 2 (2-3) vs. 4 (2-4), 2 (2-3) vs. 5 (3-5), 3 (2-3) vs. 5 (3-5), P <0.05). There was no significant difference in VAS scores (T0 and T5), SBP, DBP and HR between these two groups.
Conclusion: Ultrasound - guided thoracic paravertebral block achieved more effective analgesia in comparison to local infiltration groups in patients undergoing percutaneous kyphoplasty.
Figure 1
Figure 2
Figure 3
Figure 4
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