Chinese Medical Sciences Journal ›› 2022, Vol. 37 ›› Issue (1): 15-22.doi: 10.24920/003934

• Original Article • Previous Articles     Next Articles

Ultrasound-Guided Continuous Thoracic Paravertebral Block Improves Patientʼs Quality of Recovery After Open Hepatectomy: A Randomized, Double-Blind, Placebo-Controlled Trial

Xulei Cui1, Nan Xu1, Zhiyong Zhang1, Bo Zhu1, Yuelun Zhang2, Yongchang Zheng3, Shunda Du3, Yilei Mao3, Xinting Sang3, Yuguang Huang1, *()   

  1. 1Anesthesiology Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    2Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    3Hepatobiliary Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2021-05-14 Accepted:2021-09-28 Published:2022-03-31 Online:2022-03-03
  • Contact: Yuguang Huang E-mail:garypumch@163.com
Ultrasound-guided continuous thoracic paravertebral block (CTPVB) can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy. However, the impact of this analgesic technique on quality of life (QoL) after open hepatectomy has not yet been evaluated. In this prospective, randomized, double-blind, placebo-controlled study, the authors assessed patients’ perception of recovery following open hepatectomy with CTPVB using the validated Chinese 15-item QoR (QoR-15C) questionnaire. It was found that perioperative CTPVB enhanced the QoR in patients undergoing open hepatectomy. In addition, this technique provided significant analgesia in the early postoperative period and also had an opioid-sparing effect.

Background Ultrasound-guided continuous thoracic paravertebral block can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy. We hypothesize that these effects may improve the quality of recovery (QoR) after open hepatectomy.
Methods Seventy-six patients undergoing open hepatectomy were randomized to receive a continuous thoracic paravertebral block with ropivacaine (CTPVB group) or normal saline (control group). All patients received patient-controlled intravenous analgesia with morphine postoperatively for 48 hours. The primary outcome was the global Chinese 15-item Quality of Recovery score on postoperative day 7, which was statistically analyzed using Student’s t-test.
Results Thirty-six patients in the CTPVB group and 37 in the control group completed the study. Compared to the control group, the CTPVB group had significantly increased global Chinese 15-item Quality of Recovery scores (133.14 ± 12.97 vs. 122.62 ± 14.89, P = 0.002) on postoperative day 7. Postoperative pain scores and cumulative morphine consumption were significantly lower for up to 8 and 48 hours (P < 0.05; P = 0.002), respectively, in the CTPVB group.
Conclusion Perioperative CTPVB markably promotes patient’s QoR after open hepatectomy with a profound analgesic effect in the early postoperative period.

Key words: thoracic paravertebral block, hepatectomy, quality of recovery, ropivacaine

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