Effect of ultrasound-guided L1/L2 paravertebral block in decreasing drug requirements during general anesthesia in patients undergoing hip surgeries; randomized controlled trial

Abstract

Background: The aim of this study is to investigate that combinig Lumbar paravertebral block and GA decreases postoperative pain, blood loss and the need for hypotensive drugs. Methods: After ethical committee approval. A randomized, controlled; double-blinded study registered (NCTR 03422354). The study was conducted in Cairo university hospital from 15/02/2018/to 21/06/2018. Seventy-four patients were randomly allocated into two groups using computerized generated random tables: Group P: 37 patients received single-shot L1-L2 paravertebral block before GA. And Group G: 37 patients received GA. The primary outcome was the required dose of hypotensive drugs in both groups. Results: There were no statistical differences in hypotensive drug requirements between both groups. On the other hand, there were remarkable differences in all analgesics that were used in both groups as the total doses were much less in the group (P) than in the group (G). There was a statistically significant decrease in both MBP and HR in the group (P) in 30, 60 and 120 min after induction of anesthesia. Group P showed a lower level of VAS with statistical differences in the first 30 min after recovery and the subsequent 4 h (2 and 4). After 4 h the VAS was low in both groups and was noncomparable between the two groups. Conclusion: U/S guided L1/L2 PVB produces proper intraoperative hemodynamic control. It is also a safe and excellent alternative of analgesia that decreases the perioperative opioids requirements. However, there were no difference in the total dose of hypotensive drugs and the total blood loss.