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| Year : 1999 | Volume
: 4
| Issue : 3 | Page : 128-133 |
An evaluation of thoracic paraverteb block in the management of intraoperative pain in thoracotomy in children
YK Batra, L Anand, HG Sudarshana, P Chari, KL Rao
Department of Anaesthesiology and Pediatric Surgery Post graduate Institute of Medical Education & Research
Correspondence Address:
Y K Batra
Department of Anaesthesiology and Pediatric Surgery Post graduate Institute of Medical Education & Research
 Source of Support: None, Conflict of Interest: None  | Check |
ABSTRACT: This prospective randomized double Blind study was conducted to evaluate the efficacy of a single dose thoracic paravertebral block in the management of intraoperative pain in children. Eighteen children aged 2-7 years undergoing elective lateral thoracotomy were included in the study. Following induction and intubation the children in group I (n=9) received a single dose paravertebral block with 0.5 ml/Kg bupivacaine 0.25 percent with 1: 200,000 adrenaline, while those in group II(n=9)were given an equivalent volume of 0.9 percent saline. Heart rate (HR), mean arterial pressure(MAP) and the rate pressure product(RPP)were determined at preincision(basal),skin incision, rib retraction, rib retraction release and skin closure. In group I a significant increase in HR from 98.44+-5.22 to 106.11+-6.0 at skin incision and from 98.44+-5.22 to 107.56+-5.54 during rib retraction was seen(p0.01), whereas in group II the HR remained elevated significantly at the above mentioned specific time intervals(p0.01). The MAP in group I remained stable following the block and there was no significant change from the basal value. However, in group II the MAP was significantly higher following skin incision (75.48+-4.22 to 81.63+-2.26),at rib retraction(75.48+-4.22 to 82.37+-3.83) and also at rib retraction release and during skin closure(p0.01). There was also a significant rise in the RPP in group II at all the time intervals (p0.001). The date suggest that a single dose of thoracic paravertebral block with bupivacaine administered following induction of anaesthesia is safe and effective in the hemodynamic responses to painful stimuli in patients undergoing lateral thoracotomy.
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