Effect of Paravertebral Block on the Outcomes of Patients Undergoing Video-Assisted Thoracic Surgery

2.50
Hdl Handle:
http://hdl.handle.net/10755/621987
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Effect of Paravertebral Block on the Outcomes of Patients Undergoing Video-Assisted Thoracic Surgery
Other Titles:
Surgical Pain Management
Author(s):
Torres, Myra I.; Minnich, Linda A.
Lead Author STTI Affiliation:
Lambda Gamma
Author Details:
Myra I. Torres, MSN, RN-BC, PCCN, Professional Experience: 2001- present --Nurse Clinician with experience with Medical and Surgical patients, Cardiac Step-down units, Cardiac surgery patients and Ambulatory Surgery patients. Over 10 years direct bedside care experience of taking care of thoracic surgery patients with paravertebral blocks pre-operatively and post-operatively. 2012-2016-- Assistant professor of ADN & BSN program Author Summary: I am currently Nurse Clinician in a small community hospital. Over 23 years of nursing experience, 16 years in acute care setting. Experienced in Medical and Surgical, Cardiac Step-down, Cardiac surgery and Ambulatory Surgery units. Over 13 years direct bedside care experience with thoracic surgery patients who had paravertebral blocks pre-operatively and post-operatively. Certified in PCCN and Cardiac Vascular Nursing. Also an Assistant professor for Medical Surgical nursing courses ADN & BSN program.
Abstract:

Purpose:

The purpose of this study was to determine if there was a relationship between the introduction of paravertebral block pre-operatively and patient’s post-operative pain scores, length of urinary catheter use and length of hospital stay.

Methods:

The study design is retrospective data collection of 40 patients undergoing Video-Assisted Thoracic Surgery (VATS) with wedge resection at a small community hospital in Northern California between March 2013 and March 2015. The decision on whether to apply paravertebral block was based on surgeon preference. All patients included in the study received the usual surgical pain regimen of systemic opioids. At the Post-anesthesia care unit, all patients receive systemic opioids using patient controlled analgesia (PCA) until post-op day 2.

Half of the patients (control group) did not receive the paravertebral block, while the other half received paravertebral block pre-operatively. Those who received paravertebral block had a continuous infusion from the pre-operative period up to 48 hours after surgery.

Convenience sampling was used. No patient was identified by name or MRN number. Permission to study was granted by the hospital nursing research committee Wilcoxon signed-rank test was used.

Results:

VATS patients who received paravertebral blocks reported lower pain scores from the afternoon of post-op day 2 until post op day 4 (p= 0.04 on post-op day 2, p=0.006 & p=0.08 on day 3, p=0.03 & 0.06 on day 4), had earlier urinary catheter removal (p= <0.001) and had shorter length of stay (p= 0.0017) compared to patients who did not receive paravertebral blockade. Patients had no demographic differences other than average body mass index (BMI), which was higher in the treatment group (p=0.006) and may have contributed to a surgeon’s decision on whether or not to use paravertebral blockade.

 Conclusion:

The study shows that paravertebral blockade in patients who are undergoing thoracic surgery with wedge resection can have beneficial patient outcomes such as decreased pain levels, shorter urinary catheter use and decreased hospital length of stay. All of these, in turn, may be factors in increasing patient satisfaction, preventing device-related infection, increasing hospital reimbursement and decreasing hospital costs.

Keywords:
paravertebral block; patient outcomes; video-assisted thoracic surgery
Repository Posting Date:
20-Jul-2017
Date of Publication:
20-Jul-2017
Other Identifiers:
INRC17N16
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleEffect of Paravertebral Block on the Outcomes of Patients Undergoing Video-Assisted Thoracic Surgeryen_US
dc.title.alternativeSurgical Pain Managementen
dc.contributor.authorTorres, Myra I.en
dc.contributor.authorMinnich, Linda A.en
dc.contributor.departmentLambda Gammaen
dc.author.detailsMyra I. Torres, MSN, RN-BC, PCCN, Professional Experience: 2001- present --Nurse Clinician with experience with Medical and Surgical patients, Cardiac Step-down units, Cardiac surgery patients and Ambulatory Surgery patients. Over 10 years direct bedside care experience of taking care of thoracic surgery patients with paravertebral blocks pre-operatively and post-operatively. 2012-2016-- Assistant professor of ADN & BSN program Author Summary: I am currently Nurse Clinician in a small community hospital. Over 23 years of nursing experience, 16 years in acute care setting. Experienced in Medical and Surgical, Cardiac Step-down, Cardiac surgery and Ambulatory Surgery units. Over 13 years direct bedside care experience with thoracic surgery patients who had paravertebral blocks pre-operatively and post-operatively. Certified in PCCN and Cardiac Vascular Nursing. Also an Assistant professor for Medical Surgical nursing courses ADN & BSN program.en
dc.identifier.urihttp://hdl.handle.net/10755/621987-
dc.description.abstract<p><strong>Purpose:</strong></p> <p>The purpose of this study was to determine if there was a relationship between the introduction of paravertebral block pre-operatively and patient’s post-operative pain scores, length of urinary catheter use and length of hospital stay.</p> <p><strong>Methods:</strong></p> <p>The study design is retrospective data collection of 40 patients undergoing Video-Assisted Thoracic Surgery (VATS) with wedge resection at a small community hospital in Northern California between March 2013 and March 2015. The decision on whether to apply paravertebral block was based on surgeon preference. All patients included in the study received the usual surgical pain regimen of systemic opioids. At the Post-anesthesia care unit, all patients receive systemic opioids using patient controlled analgesia (PCA) until post-op day 2.</p> <p>Half of the patients (control group) did not receive the paravertebral block, while the other half received paravertebral block pre-operatively. Those who received paravertebral block had a continuous infusion from the pre-operative period up to 48 hours after surgery.</p> <p>Convenience sampling was used. No patient was identified by name or MRN number. Permission to study was granted by the hospital nursing research committee Wilcoxon signed-rank test was used.</p> <p><strong>Results:</strong></p> <p>VATS patients who received paravertebral blocks reported lower pain scores from the afternoon of post-op day 2 until post op day 4 (p= 0.04 on post-op day 2, p=0.006 & p=0.08 on day 3, p=0.03 & 0.06 on day 4), had earlier urinary catheter removal (p= <0.001) and had shorter length of stay (p= 0.0017) compared to patients who did not receive paravertebral blockade. Patients had no demographic differences other than average body mass index (BMI), which was higher in the treatment group (p=0.006) and may have contributed to a surgeon’s decision on whether or not to use paravertebral blockade.</p> <p> <strong>Conclusion:</strong></p> <p>The study shows that paravertebral blockade in patients who are undergoing thoracic surgery with wedge resection can have beneficial patient outcomes such as decreased pain levels, shorter urinary catheter use and decreased hospital length of stay. All of these, in turn, may be factors in increasing patient satisfaction, preventing device-related infection, increasing hospital reimbursement and decreasing hospital costs.</p>en
dc.subjectparavertebral blocken
dc.subjectpatient outcomesen
dc.subjectvideo-assisted thoracic surgeryen
dc.date.available2017-07-20T16:15:48Z-
dc.date.issued2017-07-20-
dc.date.accessioned2017-07-20T16:15:48Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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