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Study aim
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To compare the clinical outcomes and analgesic efficacy in patient’s post-thoracotomy treated with extra pleural paravertebral block (PVB) versus thoracic epidural anesthesia (TEA)
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Design
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A prospective, two-arm, parallel-group, non-randomized clinical trial comparing extra pleural paravertebral block and thoracic epidural block for post-thoracotomy pain. Participants will be allocated to either group without randomization. No blinding will be performed. sample size 140 Participants.
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Settings and conduct
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This quasi-experimental study was carried out at the Department of Anesthesiology, Combined Military Hospital, Rawalpindi from Jan-Jun 2024.
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Participants/Inclusion and exclusion criteria
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Inclusion Criteria: ASA-II and III male and female patients between ages 25-65 years presenting in the pre-anesthesia clinic planned for an elective diagnostic and/or therapeutic thoracotomy.
Exclusion Criteria: Patients with metastatic disease, major cardiac or respiratory disease, low ejection fraction, post chemotherapy, allergy to lignocaine and/or bupivacaine, unwilling to be included in the study, infection at site of block, coagulation disorders, ineffective regional block, and failure to perform block after three consecutive attempts by a consultant pain specialist
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Intervention groups
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The patients were divided into Group A (n=70) to receive Paravertebral block (PVB) and Group B (n=70) to receive thoracic epidural anesthesia (TEA)
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Main outcome variables
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Primary variables studied were median Visual Analogue Scale Score for first 24 hours after 6 hour intervals and mean dose of added rescue analgesia (Intavenous Nalbuphine 0.15 mg/kg) required once pain scores reached above 5 on the Visual Analogue Scal scale for all patients.