NDLI: Paravertebral block analgesia during surgical stabilization for rib fractures patients under conscious state: a single-arm, pilot study and post-hoc analysis

Content Provider	Springer Nature : BioMed Central
Author	Wu, Weiming Gao, Xiaoyun Liu, Penghao Zhao, Weigang Yang, Yi
Abstract	Background Paravertebral block (PVB) is commonly used for analgesia postoperatively while rarely as anesthesia during surgical stabilization for rib fractures. This study aimed to explore the feasibility and safety of PVB analgesia alone during surgical stabilization for patients with multiple rib fractures (MRF) under conscious state. Methods This prospective single-arm pilot study was conducted in patients with MRF who schedule for surgical stabilization using PVB analgesia in Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between September 2019 and September 2020. The outcomes were the vital signs, postoperative pain and nausea and vomiting (PONV). Those who underwent general anesthesia (GA) during the same period were included for post hoc analysis. Results Eighteen patients (aged 62 ± 10.64 years; 8 males) were enrolled. The vital signs, including SpO2, systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, of the patients at baseline, perioperative, intraoperative, and postoperative day 1 were kept normal. The postoperative numerical rating scale (NRS) pain scores at 6, 12, and 24 h were 2.67 ± 1.36, 2.44 ± 0.80, and 2.33 ± 0.86, respectively, which were improved compared with baseline (5.78 ± 1.00). No PONV, postoperative morbidity, pulmonary infections, or incision infections were observed. Additionally, post-hoc analysis for the comparison of patients who underwent GA with PVB (in the pilot study) showed a similar number of rib fracture fixation (P = 0.06) and analgesic effect (P = 0.06) after operation, while a significantly shorter total length of hospital stay (P < 0.01), postoperative hospital stay (P < 0.01), lower dose of sufentanil citrate use (P < 0.01),and total costs(P < 0.03)in patients who underwent PVB. Conclusions PVB analgesia during surgical stabilization for MRF under a conscious state might be feasible and safe. Compared with GA, PVB analgesia might reduce the dose of narcotics, shorten the length of hospital stay, and reduce the cost of hospitalization. Clinical registration : www.clinicaltrials.gov (#NCT04536311).
Related Links	https://cardiothoracicsurgery.biomedcentral.com/counter/pdf/10.1186/s13019-025-03397-8.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	17498090
DOI	10.1186/s13019-025-03397-8
Journal	Journal of Cardiothoracic Surgery
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2025-03-21
Access Restriction	Open
Subject Keyword	Cardiac Surgery Thoracic Surgery Surgical stabilization Multiple rib fractures Conscious state Paravertebral block Pilot study
Content Type	Text
Resource Type	Article
Subject	Surgery Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine
Journal Impact Factor	1.5/2023
5-Year Journal Impact Factor	1.6/2023

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