The Analgesic Effects of Thoracic Paravertebral Block versus Thoracic Epidural Anesthesia After Thoracoscopic Surgery: A Meta-Analysis

Content Provider	Scilit
Author	Liang, Xiao-Long An, Ran Chen, Qi Liu, Hong-Liang
Copyright Year	2021
Description	Background: To date, there is no definitive evidence for the analgesic effects and side effects of thoracic epidural anesthesia (TEA) versus thoracic paravertebral block (TPVB) after thoracoscopic surgery. In this study, we conducted a meta-analysis of published randomized clinical trials (RCTs) to analyze the analgesic effects of TEA versus TPVB after thoracoscopic surgery. Methods: We systematically searched RCTs published by October 26, 2020, in PubMed, EMBASE, and Cochrane library and conducted a meta-analysis to analyze the analgesic effects of TEA versus TPVB after thoracoscopic surgery. The primary measure was postoperative pain score, and the secondary measures were postoperative 24-hour usage of opioids, hypotension, postoperative nausea, and vomiting. Results: A total of 458 patients from five RCTs were included in this study. After thoracoscopic surgery, the numerical rating scale (NRS) score for resting pain was higher in the TPVB group than in the TEA group at 1– 2 hours and 4– 6 hours after surgery (MD = 0.44, 95% CI = 0.24 to 0.64, P < 0.0001, I2 = 0%; MD = 0.47, 95% CI = 0.23 to 0.70, P < 0.0001, I2 = 0%). The postoperative 24-hour usage of morphine was higher in the TPVB group than in the TEA group (SMD = 0.67; 95% CI = 0.03 to 1.31; P = 0.04; I2 = 84%). The incidence of hypotension was significantly lower in the TPVB group than in the TEA group (OR = 4.52; 95% CI = 2.03 to 10.10; P = 0.0002; $I^{2}$ = 0%). No significant between-group difference was observed in postoperative nausea and vomiting (PONV). Conclusion: Compared with TPVB, TEA provides statistically significant but clinically unimportant short-term benefits following thoracoscopic surgery.
Related Links	https://www.dovepress.com/getfile.php?fileID=68044
Ending Page	825
Page Count	11
Starting Page	815
ISSN	11787090
DOI	10.2147/jpr.s299595
Journal	Journal of Pain Research
Volume Number	14
Language	English
Publisher	Informa UK Limited
Publisher Date	2021-03-01
Access Restriction	Open
Subject Keyword	Anesthesiology Thoracic Paravertebral Block Thoracic Epidural Anesthesia Thoracoscopic Surgery Meta-analysis
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine