<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1134-8046</journal-id>
<journal-title><![CDATA[Revista de la Sociedad Española del Dolor]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Soc. Esp. Dolor]]></abbrev-journal-title>
<issn>1134-8046</issn>
<publisher>
<publisher-name><![CDATA[Inspira Network Group, S.L ]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1134-80462017000200068</article-id>
<article-id pub-id-type="doi">10.20986/resed.2016.3474/2016</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Comparison of two concentrations of bupivacaine by continuous paravertebral infusion after thoracotomy with pulmonary resection: a double-blind, randomized clinical trial]]></article-title>
<article-title xml:lang="es"><![CDATA[Comparación de dos concentraciones de bupivacaína en infusión continua para vertebral para tratamiento del dolor de toracotomía con resección pulmonar: ensayo clínico aleatorizado doble ciego]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zabaleta]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mugabure]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortiz-de-Urbina]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Imaz]]></surname>
<given-names><![CDATA[L. C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguinagalde]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Izquierdo]]></surname>
<given-names><![CDATA[J. M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Donostia University Hospital Thoracic Surgery Service ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Donostia University Hospital Service of Anesthesia. Acute Pain Unit]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2017</year>
</pub-date>
<volume>24</volume>
<numero>2</numero>
<fpage>68</fpage>
<lpage>73</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1134-80462017000200068&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1134-80462017000200068&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1134-80462017000200068&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background and objectives:  Post-thoracotomy pain management should be based on a multimodal approach that includes continuous regional analgesia. The objective of this study was to compare the analgesic efficacy of two concentrations of bupivacaine (0.2 % and 0.3 %) through a paravertebral catheter, both group plus fentanyl 2 mcg/ml.  Methods:  We conducted a randomized double-blind clinical trial to compare these two concentrations in patients undergoing pulmonary resection by thoracotomy in Donostia University Hospital between November 2010 and May 2011 (n = 59). The paravertebral catheter was placed prior to the surgical intervention, with the patient awake and sitting upright. Data were analyzed on an intention-to-treat basis. The Chi-squared test was used for qualitative variables and Student's t-tests or Mann-Whitney-Wilcoxon tests for quantitative variables, depending on the distribution of the variables. Statistical analysis was performed using IBM SPSS software (Version 17).  Results:  We did not find statistically significant differences in postoperative pulmonary function (p = 0.49), self-perceived pain (VAS; p = 0.28) or cumulative morphine consumption (p = 0.101) in the two groups. We observed adverse effects in 8 patients in group 1 (29.6 %) and in 12 patients (37.5 %) in group 2, the difference not being statistically significant (p = 0.52).  Conclusions:  Continuous thoracic paravertebral block for 48 hours is a good technique for the management of postoperative pain after pulmonary resection by thoracotomy. With moderate doses of local anesthetics (bupivacaine 0.20 %) we achieved good pain control and observed few systemic complications than major doses (bupivacaine 0.30 %).]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Antecedentes y objetivos:  El manejo del dolor post-toracotomía debe basarse en un enfoque multimodal que incluye la analgesia regional continua. El objetivo de este estudio fue comparar la eficacia analgésica de dos concentraciones de bupivacaína (0,2 y 0,3 %) a través de un catéter paravertebral, ambos grupos más fentanilo 2 mcg/ml.  Material y métodos:  Se realizó un ensayo clínico aleatorizado, doble ciego, para comparar estas dos concentraciones en pacientes sometidos a resección pulmonar por toracotomía en el Hospital Universitario Donostia entre noviembre de 2010 y mayo de 2011 (n = 59). El catéter paravertebral se colocó antes de la intervención quirúrgica, con el paciente despierto en posición sentada. Los datos se analizaron sobre la base de intención de tratar. Se utilizó la prueba de Chi cuadrado para variables cualitativas y la t de Student o pruebas de Mann-Whitney-Wilcoxon para las variables cuantitativas, en función de la distribución de las variables. El análisis estadístico se realizó utilizando el software de IBM SPSS (versión 17).  Resultados:  No se encontraron diferencias estadísticamente significativas en la función pulmonar postoperatoria (p = 0,49), la percepción subjetiva de dolor (VAS; p = 0,28) o el consumo de morfina acumulada (p = 0,101) en los dos grupos. Hemos observado efectos adversos en 8 pacientes del grupo 1 (29,6 %) y en 12 pacientes (37,5 %) del grupo 2; la diferencia no fue estadísticamente significativa (p = 0,52).  Conclusiones:  El bloqueo paravertebral torácico continuo durante 48 horas es una buena técnica para el manejo del dolor postoperatorio después de la resección pulmonar por toracotomía. Con dosis moderadas de anestésicos locales (bupivacaína 0,20 %) se logró un buen control del dolor y observamos un número menor de complicaciones sistémicas que el grupo de dosis mayores (bupivacaína 0,30 %).]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Postoperative pain]]></kwd>
<kwd lng="en"><![CDATA[thoracotomy]]></kwd>
<kwd lng="en"><![CDATA[paravertebral blockade]]></kwd>
<kwd lng="en"><![CDATA[analgesia]]></kwd>
<kwd lng="en"><![CDATA[bupivacaine]]></kwd>
<kwd lng="es"><![CDATA[Dolor postoperatorio]]></kwd>
<kwd lng="es"><![CDATA[toracotomía]]></kwd>
<kwd lng="es"><![CDATA[bloqueo paravertebral]]></kwd>
<kwd lng="es"><![CDATA[analgesia]]></kwd>
<kwd lng="es"><![CDATA[bupivacaína]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Acute pain management for patients undergoing thoracotomy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Soto]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Fu]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Thorac Surg]]></source>
<year>2003</year>
<volume>75</volume>
<page-range>1349-57</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy: a systematic review and meta-analysis of randomized trials]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Davies]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Myles]]></surname>
<given-names><![CDATA[PS]]></given-names>
</name>
<name>
<surname><![CDATA[Graham]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<source><![CDATA[Br J Anaesth]]></source>
<year>2006</year>
<volume>96</volume>
<page-range>418-26</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Update on the role of paravertebral blocks for thoracic surgery are they worth it?]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Daly]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Myles]]></surname>
<given-names><![CDATA[PS]]></given-names>
</name>
</person-group>
<source><![CDATA[Curr Opin Anaesthesiol]]></source>
<year>2009</year>
<volume>22</volume>
<page-range>38-43</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Multimodal approaches to postoperative pain management and convalescence]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mugabure Bujedo]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Tranque Bizueta]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[González Santos]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Adrián Garde]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Esp Anestesiol Reanim]]></source>
<year>2007</year>
<volume>54</volume>
<page-range>29-40</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Joshi]]></surname>
<given-names><![CDATA[GP]]></given-names>
</name>
<name>
<surname><![CDATA[Kehlet]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Rawal]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evidence-based guidelines for postoperative pain management]]></article-title>
<collab>PROSPECT Working Group</collab>
<source><![CDATA[Reg Anesth Pain Med]]></source>
<year>2007</year>
<volume>32</volume>
<page-range>173</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Perioperative pain management after thoracotomy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wenk]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Schug]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
</person-group>
<source><![CDATA[Curr Opin Anaesthesiol]]></source>
<year>2011</year>
<volume>24</volume>
<page-range>8-12</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Efficacy and safety of different techniques of paravertebral block for analgesia after thoracotomy a systematic review and metaregression]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kotzé]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Scally]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Howell]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Br J Anaesth]]></source>
<year>2009</year>
<volume>103</volume>
<page-range>626-36</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Efficacy of methods of intercostal nerve blockade for pain relief after thoracotomy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Detterbeck]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Thorac Surg]]></source>
<year>2005</year>
<volume>80</volume>
<page-range>1550-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A systematic review of randomized trials evaluating regional techniques for post-thoracotomy analgesia]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Joshi]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Bonnet]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Wilkinson]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Camu]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Fischer]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<source><![CDATA[Anesth Analg]]></source>
<year>2008</year>
<volume>107</volume>
<page-range>1026-40</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A systematic review of comparative studies indicates that paravertebral block is neither superior nor safer than epidural analgesia for pain after thoracotomy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Norum]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
<name>
<surname><![CDATA[Breivik]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<source><![CDATA[Scand J Pain]]></source>
<year>2010</year>
<volume>1</volume>
<page-range>12-23</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Published evidence from randomised trials indicates that pain after thoracotomy is more effectively relieved by thoracic epidural analgesia than by paravertebral blocks]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Norum]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
<name>
<surname><![CDATA[Breivik]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<source><![CDATA[Eur J Anaesthesiol]]></source>
<year>2013</year>
<volume>30</volume>
<page-range>261</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Perioperative pain management after thoracotomy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wenk]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Schug]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
</person-group>
<source><![CDATA[Curr Opin Anaesthesiol]]></source>
<year>2011</year>
<volume>24</volume>
<page-range>8-12</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Pain relief with paravertebral blocks or epidural analgesia? Those who do not know the history of paravertebral blocks are condemned to rediscover the complications]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Niemi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Breivik]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<source><![CDATA[Scand J Pain]]></source>
<year>2010</year>
<volume>1</volume>
<page-range>3-4</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Case report. Systemic local anaesthetic toxicity from continuous thoracic paravertebral block]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fagenholz]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Bowler]]></surname>
<given-names><![CDATA[GMR]]></given-names>
</name>
<name>
<surname><![CDATA[Carnochan]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
<name>
<surname><![CDATA[Walker]]></surname>
<given-names><![CDATA[WS]]></given-names>
</name>
</person-group>
<source><![CDATA[Br J Anaesth]]></source>
<year>2012</year>
<volume>109</volume>
<page-range>260-2</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Plasma concentrations of bupivacaine and its enantiomers during continuous extrapleural intercostal nerve block]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berrisford]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Sabanathan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Mearns]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Clarke]]></surname>
<given-names><![CDATA[BJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hamdi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Br J Anaesth]]></source>
<year>1993</year>
<volume>70</volume>
<page-range>201-4</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Local anesthetic systemic toxicity]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dillane]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Finucane]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
</person-group>
<source><![CDATA[Can J Anaesth]]></source>
<year>2010</year>
<volume>57</volume>
<page-range>368-80</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Thoracic paravertebral space location. A new method using pressure measurement]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Richardson]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cheema]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Hawkins]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Sabanathan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Anaesthesia]]></source>
<year>1996</year>
<volume>51</volume>
<page-range>137-9</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Lateral ultrasound-guided paravertebral blockade: an anatomical- based description of a new technique]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marhofer]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Kettner]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Hajbok]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Dubsky]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Fleischmann]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Br J Anaesth]]></source>
<year>2010</year>
<volume>105</volume>
<page-range>526-32</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
