Article of the Month – June 2016

“Paravertebral block versus thoracic epidural for patients undergoing thoracotomy”

URLhttp://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009121.pub2/full
DOI: 10.1002/14651858.CD009121.pub2
Published: 21 February 2016

Authors: Yeung JHY, Gates S, Naidu BV, Wilson MJA, Gao Smith F
In this Cochrane review, the authors included 14 studies involving 698 participants comparing the analgesic efficacy of paravertebral block (PVB) and thoracic epidural analgesia (TEA) in participants undergoing open thoracotomy.
Main Objective: Does the PVB have the potential to lower risk of major complications after open thoracotomy?

Main findings:
•    They found no difference between PVB and TEA in terms of death at 30 days and major complications.
•    PVB appeared to be as effective as TEA in pain control post-surgery.
•    TEB was associated with minor complications such as low blood pressure, nausea and vomiting, itching and urinary retention when compared to PVB.

Clinical impact: After reading of this interesting review can we try to answer the following queries?
1.    Can this review potentially change our current daily practice?
2.    Revisited: Does every post-thoracotomy patient deserve TEA?
3.    How often do everyone face with failed PVB?

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