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BMC Anesthesiology

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Open Access 01-12-2023 | Morphine | Research

The effect of body mass index on thoracic paravertebral block analgesia after video-assisted thoracoscopic surgery; a prospective interventional study

Authors: Emine Nilgün Zengin, Ali Alagöz, Hülya Yiğit, Hilal Sazak, Sumru Şekerci, Musa Zengin

Published in: BMC Anesthesiology | Issue 1/2023

Abstract

Background

To investigate the effects of body mass index (BMI) on intensity postoperative pain in patients who underwent thoracic paravertebral block (TPVB) for postoperative analgesia after video-assissted thoracoscopic surgery (VATS).

Methods

Patients aged 18–80 years, ASA I-III, and BMI 18–40 kg/m² who underwent elective VATS were included in the study. The patients were divided into 3 groups according to their BMI levels. TPVB was performed under ultrasound-guidance at the fifth thoracic vertebrae, and 30 ml of 0.25% bupivacaine was injected. The patient-controlled analgesia (PCA) was performed by using morphine and multimodal analgesia was performed. As a rescue analgesic agent, 0.5 mg/kg tramadol was given to patients intravenously when a score of visual analog scale (VAS) at rest was ≥ 4. The primary outcome was determined as VAS scores at rest and cough. Secondary outcomes were determined as postoperative morphine consumption, additional analgesic requirement, and side effects.

Results

The post-hoc test revealed that the VAS resting scores at the 4^th hour (p: 0.007), 12^th hour (p: 0.014), and 48^th hour (p: 0.002) were statistically significantly lower in Group I compared to Group II. Additionally, VAS resting scores were also statistically significantly lower in Group I compared to Group III at all time points (p < 0.05). Similarly, the post-hoc test indicated that the VAS coughing scores at the 4^th hour (p: 0.023), 12^th hour (p: 0.011), and 48^th hour (p: 0.019) were statistically significantly lower in Group I compared to Group II. Moreover, VAS coughing scores were statistically significantly lower in Group I compared to Group III at all time points (p < 0.001). Furthermore, there were statistically significant differences in terms of additional analgesic use between the groups (p: 0.001). Additionally, there was a statistically significant difference in terms of morphine consumption via PCA and morphine milligram equivalent consumption between the groups (p < 0.001).

Conclusions

Higher postoperative VAS scores with TPVB applied in obese patients and the consequent increase in additional analgesics and complications require more specific postoperative management in this patient group.

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Title: The effect of body mass index on thoracic paravertebral block analgesia after video-assisted thoracoscopic surgery; a prospective interventional study
Authors: Emine Nilgün Zengin
Ali Alagöz
Hülya Yiğit
Hilal Sazak
Sumru Şekerci
Musa Zengin
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Morphine
Analgesics in Dentistry
Published in: BMC Anesthesiology / Issue 1/2023
Electronic ISSN: 1471-2253
DOI: https://doi.org/10.1186/s12871-023-02264-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The effect of body mass index on thoracic paravertebral block analgesia after video-assisted thoracoscopic surgery; a prospective interventional study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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