Efficacy of Methylene Blue Thoracic Paravertebral Block in Postoperative Pain After VATS Lobectomy

Annals of thoracic surgery short reports Pub Date : 2024-06-01 DOI:10.1016/j.atssr.2023.12.013

Beatrice Leonardi MD , Giovanni Natale MD , Francesco Leone MD , Gaetana Messina MD , Roberta Fiorito MD , Francesco Coppolino MD , Maria Caterina Pace MD , Paolo Chiodini MD , Marina Di Domenico MD , Alfonso Fiorelli PhD

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Abstract

Background

Paravertebral block (PVB) is effective in controlling postoperative pain after video-assisted thoracoscopic surgery (VATS) lobectomy but is subject to a high rate of failure because of incorrect site of injection. We compared methylene blue PVB with thoracic epidural anesthesia (TEA) for postoperative pain after VATS lobectomy.

Methods

We conducted a prospective randomized trial of patients undergoing VATS lobectomy; 120 patients were randomly assigned to the PVB or TEA group. The end points were postoperative pain at 1 hour, 12 hours, 24 hours, and 48 hours; time to perform TEA and PVB; opioid consumption; and postoperative outcomes.

Results

PVB was associated with reduction of local anesthesia time (P < .0001). In 2 cases, methylene blue showed that the block was not well performed; thus, it was repeated. No significant differences were found in postoperative pain, opioid consumption, and postoperative outcomes.

Conclusions

PVB with methylene blue is as effective as TEA for controlling postoperative pain. Methylene blue use could help reduce PVB failure.

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亚甲蓝胸椎旁阻滞对大鼠肺叶切除术后疼痛的疗效

背景椎旁阻滞（PVB）能有效控制视频辅助胸腔镜手术（VATS）肺叶切除术后的疼痛，但由于注射部位不正确，失败率很高。我们比较了亚甲蓝 PVB 和胸硬膜外麻醉（TEA）对 VATS 肺叶切除术后疼痛的治疗效果。方法我们对接受 VATS 肺叶切除术的患者进行了前瞻性随机试验，120 名患者被随机分配到 PVB 组或 TEA 组。终点是术后 1 小时、12 小时、24 小时和 48 小时的疼痛；进行 TEA 和 PVB 的时间；阿片类药物的消耗量；以及术后结果。结果 PVB 与局部麻醉时间的缩短有关（P < .0001）。在 2 个病例中，亚甲蓝显示阻滞效果不佳，因此需要重复阻滞。在术后疼痛、阿片类药物用量和术后效果方面没有发现明显差异。亚甲蓝的使用有助于减少 PVB 失败。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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