Journal of Pain Research (Jul 2023)

Comparison of Edge of Lamina Block with Thoracic Paravertebral Block and Retrolaminar Block for Analgesic Efficacy in Adult Patients Undergoing Video-Assisted Thoracic Surgery: A Prospective Randomized Study

  • Gao X,
  • Chen M,
  • Liu P,
  • Zhou S,
  • Kong S,
  • Zhang J,
  • Cao J

Journal volume & issue
Vol. Volume 16
pp. 2375 – 2382

Abstract

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Xiaoyun Gao,* Moxi Chen,* Penghao Liu, Shenyuan Zhou, Sai Kong, Junfeng Zhang, Jun Cao Department of Anesthesiology, Shanghai Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jun Cao, Department of Anesthesiology, Shanghai Sixth People’s Hospital, No. 600, Yishan Road, Shanghai, 200233, People’s Republic of China, Tel +86 18930173661, Email [email protected]: A novel ultrasound-guided paravertebral block, the edge laminar block (ELB) was reported recently. However, it was unclear how effective ELB was in comparison with traditional blocking methods. We conducted a trial to compare the analgesic efficacy of ELB with the thoracic paravertebral block (TPVB) and the retrolaminar block (RLB) in patients undergoing video-assisted thoracic surgery (VATS).Methods: We identified 90 patients who were scheduled for VATS and randomly assigned them to three groups: ELB group (Group E), TPVB group (Group T), and RLB group (Group R). Each group underwent ELB, TPVB, and RLB, respectively, under ultrasound guidance before general anesthesia induction. All patients received post-operative routine analgesia protocol. Our primary outcome was the extent of dermatomal sensory loss on the midclavicular, midaxillary, and scapular lines, measured using a pinprick 15 minutes after the nerve block. Secondary outcomes included the intraoperative dose of sufentanil, the numerical rating scale (NRS) scores assessed in the post-anesthesia care unit (PACU) and at 6, 12, and 24 hours post-operatively, and pethidine administrated as analgesic rescue dose.Results: The percentages of nerve block range reaching the midclavicular line, midaxillary line, and scapular line in Group E were 96.7%, 93.3%, 93.3%, and 60% in Group T and 30%, 56.7%, and 96.7% in Group R, respectively. Group E had wider dermatomal sensory loss on the midclavicular line and midaxillary line compared to Group R (P

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