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Borys M, Hanych A, Czuczwar M. Paravertebral Block Versus Preemptive Ketamine Effect on Pain Intensity after Posterolateral Thoracotomies: A Randomized Controlled Trial. J Clin Med. 2020;9(3)doi: 10.3390/jcm9030793.
Borys, M., Hanych, A., & Czuczwar, M. (2020). Paravertebral Block Versus Preemptive Ketamine Effect on Pain Intensity after Posterolateral Thoracotomies: A Randomized Controlled Trial. Journal of clinical medicine, 9(3), . https://doi.org/10.3390/jcm9030793
Borys, Michał, et al. "Paravertebral Block Versus Preemptive Ketamine Effect on Pain Intensity after Posterolateral Thoracotomies: A Randomized Controlled Trial." Journal of clinical medicine vol. 9,3 (2020). doi: https://doi.org/10.3390/jcm9030793
Borys M, Hanych A, Czuczwar M. Paravertebral Block Versus Preemptive Ketamine Effect on Pain Intensity after Posterolateral Thoracotomies: A Randomized Controlled Trial. J Clin Med. 2020 Mar 14;9(3). doi: 10.3390/jcm9030793. PMID: 32183267; PMCID: PMC7141329.
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J Clin Med. 2020 Mar 14;9(3). doi: 10.3390/jcm9030793.

Paravertebral Block Versus Preemptive Ketamine Effect on Pain Intensity after Posterolateral Thoracotomies: A Randomized Controlled Trial.

Journal of clinical medicine

Michał Borys, Agata Hanych, Mirosław Czuczwar

Affiliations

  1. Second Department of Anesthesia and Intensive Therapy, Medical University of Lublin, 20-059 Lublin, Poland.
  2. Department of Anesthesia and Intensive Therapy, Podkarpackie Center of Lung Disease, 35-241 Rzeszów, Poland.
  3. Department of Anesthesia, Intensive Therapy and Pain Treatment, 39-120 S?dziszów Ma?opolski, Poland.

PMID: 32183267 PMCID: PMC7141329 DOI: 10.3390/jcm9030793

Abstract

Severe postoperative pain affects most patients after thoracotomy and is a risk factor for post-thoracotomy pain syndrome (PTPS). This randomized controlled trial compared preemptively administered ketamine versus continuous paravertebral block (PVB) versus control in patients undergoing posterolateral thoracotomy. The primary outcome was acute pain intensity on the visual analog scale (VAS) on the first postoperative day. Secondary outcomes included morphine consumption, patient satisfaction, and PTPS assessment with Neuropathic Pain Syndrome Inventory (NPSI). Acute pain intensity was significantly lower with PVB compared to other groups at four out of six time points. Patients in the PVB group used significantly less morphine via a patient-controlled analgesia pump than participants in other groups. Moreover, patients were more satisfied with postoperative pain management after PVB. PVB, but not ketamine, decreased PTPS intensity at 1, 3, and 6 months after posterolateral thoracotomy. Acute pain intensity at hour 8 and PTPS intensity at month 3 correlated positively with PTPS at month 6. Bodyweight was negatively associated with chronic pain at month 6. Thus, PVB but not preemptively administered ketamine decreases both acute and chronic pain intensity following posterolateral thoracotomies.

Keywords: ketamine; osterolateral thoracotomy; paravertebral block; thoracotomy; visual analog scale

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