Paravertebral block provides significant opioid sparing after hand-assisted laparoscopic nephrectomy: an expanded case report of 30 patients

J Endourol. 2009 Dec;23(12):1979-83. doi: 10.1089/end.2009.0095.

Abstract

Purpose: We report our experience of paravertebral block (PVB) on analgesic requirements and dynamic pain in patients presenting for hand-assisted laparoscopic nephrectomy (HALN) and compare our results with conventional opioid therapy.

Patients and methods: From October 2006 to May 2008, 30 patients (male:female ratio, 17:13) scheduled for HALN received paravertebral analgesia preoperatively. Postoperative opioid requirements and dynamic visual analog scale pain scores were determined in the recovery room and every 8 hours for 48 hours postoperatively. Data were obtained from medical records and patient interview.

Results: The paravertebral analgesia was completed in all 30 patients with a mean visual analog scale score of 3.08 (0-10). Cumulative morphine equivalent doses were 11.82 mg (0-41 mg), whereas in two other studies, it ranged from 24 to 54 mg.

Conclusion: PVBs provided excellent analgesia with significant opioid sparing in this pilot series of 30 patients with HALN. Utilization of multimodal analgesia incorporating PVB is recommended for patients presenting for HALN.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / pharmacology*
  • Female
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Nephrectomy / methods*
  • Nerve Block / methods*
  • Pain Measurement
  • Postoperative Care

Substances

  • Analgesics, Opioid