Effectiveness and safety of ultrasound-guided thoracic paravertebral block versus local anesthesia for percutaneous kyphoplasty in patients with osteoporotic compression fracture

BACKGROUND: Kyphoplasty for osteoporotic vertebral compression fractures (OVCF) is a short but painful intervention. Different anesthetic techniques have been proposed to control pain during kyphoplasty; however, all have limitations. OBJECTIVE: To compare the effectiveness and safety of ultrasound-guided thoracic paravertebral block with local anesthesia for percutaneous kyphoplasty (PKP). METHODS: In this prospective study, non-randomized patients with OVCF undergoing PKP received either ultrasound-guided thoracic paravertebral block (group P) or local anesthesia (group L). Perioperative pain, satisfaction with anesthesia, and complications were compared between the groups. RESULTS: Mean intraoperative (T1–T4) perioperative visual analog scale (VAS) scores were significantly lower in group P than in group L (2 [1–3] vs. 3 [2–4], 2 [2–3] vs. 4 [2–4], 2 [2–3] vs. 5 [3–5], and 3 [2–3] vs. 5 [3–5], respectively; P< 0.05). Investigators’ satisfaction scores, patients’ anesthesia satisfaction scores, and anesthesia re-administration intention rate were significantly higher in group P than in group L (4 [3–5] vs. 3 [2–4], 2 [2–3] vs. 2 [1–3], 90.63% vs. 69.70%; P< 0.05). There was no significant intergroup difference in complications. CONCLUSIONS: Ultrasound-guided thoracic paravertebral block has similar safety to and better effectiveness than local anesthesia in PKP.