COMPARISON BETWEEN PARAVERTEBRAL BLOCK VERSUS EPIDURAL IN PAIN MANAGEMENT OF THORACIC SURGERY.

Introduction:Good management of postoperative pain in thoracic surgery is essential. This pain leads to inefficient ventilation. Good analgesia can provide effective pain relief. Paravertebral block is an effective alternative method without the side effects of a thoracic epidural. The aim of this study is to compare the efficiency of thoracic epidural and paravertebral block in providing analgesia to patients undergoing thoracic surgery. Material and Methods:30 patients who underwent thoracic surgery between January 2018 and May 2018 in Avicenne teaching Hospital (CHU Avicenne Rabat) were randomized into two groups. One was a thoracic epidural group (15), and second was a paravertebral group (15). Both groups received 10 ml of 0.125% bupivacaine. Assessment of pain, hemodynamic parameters such as blood pressure and heart rate, failure to cough or breathe, nausea and vomiting were taken into account. Visual analog scale of pain Intensity (VASPI) at H0, H12, and H24 scores were accepted as main outcome of this study. Discussion: 18 patients (60%) were female, and 12 (40%) were male 7 patients (23.3%) were among the age group (18-30), 13 patients (43.3%) were among the age group (31-60), and 10 patients (33.3%) were among the age group (61-90). 26(86.7%) patients underwent surgery using the thoracotomy technique, and 4 patients (13.3%) underwent surgery using the thoracosopy technique. 63.3% of patients had a hospitalization (1 to 4 days), the rest (23.3%) had a hospitalization (4 to 7 days), and 13.3% had a hospitalization (more than 7 days). We found that VASPI scores at HO, H12 and H24, as well as heamodynamic parameters related to pain were statistically lower in paravertebral block compared with thethoracic epidural (P<0.001) Conclusion:Paravertebral block for analgesia is more efficient than thoracic epidural in thoracic surgery patients, and is associated with fewer side effects.