Paravertebral block in cardiac surgery: effect on respiratory function in patients undergoing mammary artery grafting via thoracotomy

The aim of this study was to investigate the effects of ultrasound-guided thoracic paravertebral block versus sevoflurane anesthesia on respiratory function in patients undergoing mammary artery grafting via thoracotomy

30 patients were randomized into 2 groups to receive either sevoflurane anesthesia with paravertebral block (n=15) or sevoflurane-fentanyl general anesthesia (n=15).

Pulmonary function was assessed before surgery, 24 hours after surgery and on the fourth post-operative day. Lung functions decreased on first postoperative day and returned to baseline value by fourth day in both groups. Vital capacity and forced vital capacity (p<0.01) were significantly higher at 24 h with paravertebral block compared to the general anesthesia group. There was no significant difference in the forced expiratory flow 25-75% between the 2 groups, however, in the paravertebral group these values were higher.
Patients with paravertebral block were able to cough more effectively.   

To conclude, ultrasound-guided thoracic paravertebral block appears to preserve lung function by providing better pain control and more effective coughing when compared with sevofluran-fentanyl general anesthesia.


09 / Paravertebral block in cardiac surgery: effect on respiratory function in patients undergoing mammary artery grafting via thoracotomy