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Thoracic paravertebral block

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https://www.readbyqxmd.com/read/29923954/is-a-retrolaminar-approach-to-the-thoracic-paravertebral-space-possible-a-human-cadaveric-study
#1
A Sassan Sabouri, Lane Crawford, Sarah K Bick, Ala Nozari, Thomas A Anderson
BACKGROUND AND OBJECTIVES: The retrolaminar block (RB) is used for truncal analgesia, but its mechanism of neural blockade remains obscure. We sought to learn the pattern of local anesthetic spread after thoracic RB using cadaveric models. METHODS: In 8 fresh cadavers, an ultrasound-guided T4 RB was performed with 20 mL of methylene blue 1% and bupivacaine 0.5%. For comparison, an RB at T9 in 1 cadaver and a T4 thoracic paravertebral block in another cadaver were performed...
June 19, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29913937/paravertebral-block-is-not-safer-nor-superior-to-thoracic-epidural-analgesia
#2
Gísli Vigfusson
No abstract text is available yet for this article.
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913936/a-systematic-review-of-comparative-studies-indicates-that-paravertebral-block-is-neither-superior-nor-safer-than-epidural-analgesia-for-pain-after-thoracotomy
#3
Hilde M Norum, Harald Breivik
Background The "gold standard" for pain relief after thoracotomy has been thoracic epidural analgesia (TEA). The studies comparing TEA with paravertebral block (PVB) and recent reviews recommend PVB as a novel, safer method than TEA. Methods A systematic search of the Cochrane and PubMed databases for prospective, randomized trials (RCTs) comparing TEA and PVB for post-thoracotomy analgesia was done. We assessed how TEA and PVB were performed, methods of randomization, assessment of pain relief, and complications...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29907082/paravertebral-dexmedetomidine-as-an-adjuvant-to-ropivacaine-protects-against-independent-lung-injury-during-one-lung-ventilation-a-preliminary-randomized-clinical-trial
#4
Wei Zhang, Shanfeng Zhang, Bing Li, Mingyang Sun, Jiaqiang Zhang
BACKGROUND: To investigate the effect of paravertebral dexmedetomidine as an adjuvant to ropivacaine on independent lung injury during one-lung ventilation. METHODS: In total, 120 patients who underwent elective radical resection of pulmonary carcinoma were randomly assigned to one of six groups (n = 20): normal saline (C group), ropivacaine (R group), intravenous dexmedetomidine (Div group), 0.5 μg/kg paravertebral dexmedetomidine as an adjuvant to ropivacaine (RD0...
June 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29901652/the-effects-of-preoperative-single-dose-thoracic-paravertebral-block-on-acute-and-chronic-pain-after-thoracotomy-a-randomized-controlled-double-blind-trial
#5
Xiu-Liang Li, Ye Zhang, Tian Dai, Lei Wan, Guan-Nan Ding
BACKGROUND: Patients undergoing thoracotomy frequently experience acute pain and chronic post-thoracotomy pain (CPTP). There are few articles relating to the investigations on the effects of preoperative single-dose thoracic paravertebral block (PSTPVB) on acute pain and CPTP. We tested the hypothesis that adding PSTPVB to intravenous (IV) patient-controlled analgesia (PCA) would reduce acute pain scores and decrease the incidence and intensity of CPTP. METHODS: Fifty-six patients undergoing elective thoracotomy were randomized to receive PSTPVB in addition to IV PCA (group T) or IV PCA alone (group C)...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29847363/a-comparison-of-the-incidence-of-supraventricular-arrhythmias-between-thoracic-paravertebral-and-intercostal-nerve-blocks-in-patients-undergoing-thoracoscopic-surgery-a-randomised-trial
#6
Caineng Wu, Wuhua Ma, Qingyun Cen, Qingxiang Cai, Jiyong Wang, Ying Cao
BACKGROUND: Postoperative supraventricular arrhythmias are common in patients after thoracoscopic lobectomy. Inadequate pain control has long been recognised as a significant risk factor for arrhythmias. The performance of ultrasound-guided (USG) thoracic paravertebral block (PVB) is increasing as an ideal technique for postoperative analgesia. OBJECTIVE: We conducted this study to evaluate whether a single-shot USG thoracic PVB would result in fewer postoperative supraventricular tachycardias (SVT) than intercostal nerve blocks (ICNBs) after thoracoscopic pulmonary resection...
May 29, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29805812/erector-spinae-plane-block-for-elective-laparoscopic-cholecystectomy-in-the-ambulatory-surgical-setting
#7
Kjartan Eskjaer Hannig, Christian Jessen, Uday Kant Soni, Jens Børglum, Thomas Fichtner Bendtsen
Postoperative pain after laparoscopic cholecystectomy can be severe. Despite multimodal analgesia regimes, administration of high doses of opioids is often necessary. This can further lead to several adverse effects such as drowsiness and respiratory impairment as well as postoperative nausea and vomiting. This will hinder early mobilization and discharge of the patient from the day surgery setting and is suboptimal in an Early Recovery after Surgery setting. The ultrasound-guided Erector Spinae Plane (ESP) block is a novel truncal interfascial block technique providing analgesia of the thoracic or abdominal segmental innervation depending on the level of administration...
2018: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29800270/multimodal-analgesia-using-intrathecal-diamorphine-and-paravertebral-and-rectus-sheath-catheters-are-as-effective-as-thoracic-epidural-for-analgesia-post-open-two-phase-esophagectomy-within-an-enhanced-recovery-program
#8
C L Donohoe, A W Phillips, E Flynn, C Donnison, C L Taylor, R C F Sinclair, D Saunders, A Immanuel, S M Griffin
Thoracic epidural (TE) analgesia has been the standard of care for transthoracic esophagectomy patients since the 1990s. Multimodal anesthesia using intrathecal diamorphine, local anesthetic infusion catheters (LAC) into the paravertebral space and rectus sheaths and intravenous opioid postoperatively represent an alternative option for postoperative analgesia. While TE can provide excellent pain control, it may inhibit early postoperative recovery by causing hypotension and reducing mobilization. The aim of this study is to determine whether multimodal analgesia with LAC was effective with respect to adequate pain management, and compare its impact on hypotension and mobility...
May 24, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29794944/use-of-serratus-plane-block-for-repair-of-coarctation-of-aorta-a-report-of-3-cases
#9
Abhijit Biswas, Igor Luginbuehl, Elod Szabo, Monica Caldeira-Kulbakas, Mark W Crawford, Tobias Everett
OBJECTIVES: The practice of regional anesthesia techniques (thoracic, epidural, paravertebral) in pediatric cardiac surgery enhances perioperative outcomes such as improved perioperative analgesia, decreased stress response, early extubation, and shortened hospital stay. However, these blocks can be technically challenging and can be associated with unacceptable failure rate and complications in infants. For these reasons, regional anesthesia is sometimes avoided in pediatric cardiac surgery...
May 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29794879/should-thoracic-paravertebral-blocks-be-used-to-prevent-chronic-post-surgical-pain-following-breast-cancer-surgery-a-systematic-analysis-of-evidence-in-light-of-immpact-recommendations
#10
Nasir Hussain, Uma Shastri, Colin Jl McCartney, Ian Gilron, Roger B Fillingim, Hance Clarke, Joel Katz, Peter Juni, Andreas Laupacis, Duminda Wijeysundera, Faraj W Abdallah
The role of thoracic paravertebral block (PVB) in preventing chronic post-surgical pain (CPSP) following breast cancer surgery (BCS) has gained interest, but existing evidence is conflicting, and its methodological quality is unclear. This meta-analysis evaluates efficacy of PVB, compared to Control, in preventing CPSP following BCS, in light of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) recommendations.Electronic databases were searched for randomized trials comparing PVB to Control for CPSP prevention following BCS...
May 23, 2018: Pain
https://www.readbyqxmd.com/read/29763594/patient-controlled-paravertebral-block-for-video-assisted-thoracic-surgery-a-randomized-trial
#11
Zixiang Wu, Shuai Fang, Qi Wang, Cong Wu, Tianwei Zhan, Ming Wu
BACKGROUND: Paravertebral block (PVB) has been proven to be an efficient way to control postoperative pain in patients who have undergone a thoracotomy. This study aimed to explore whether the utilization of a patient-controlled PVB can provide benefits over intravenous patient-controlled analgesia (PCA) for three-port single-intercostal video-assisted thoracic surgery. METHODS: From May 2015 to December 2016, patients who had solitary pulmonary nodules or spontaneous pneumothorax and underwent single-intercostal video-assisted thoracic surgery were randomly allocated to receive patient-controlled PVB or intravenous PCA...
May 12, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29746445/a-cadaveric-study-investigating-the-mechanism-of-action-of-erector-spinae-blockade
#12
Jason Ivanusic, Yasutaka Konishi, Michael J Barrington
BACKGROUND AND OBJECTIVES: Erector spinae block is an ultrasound-guided interfascial plane block first described in 2016. The objectives of this cadaveric dye injection and dissection study were to simulate an erector spinae block to determine if dye would spread anteriorly to the involve origins of the ventral and dorsal branches of the spinal nerves. METHODS: In 10 unembalmed human cadavers, 20 mL of 0.25% methylene blue dye was injected bilaterally into the plane between the fifth thoracic transverse process and erector spinae muscle...
May 10, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29740737/comparison-of-the-analgesic-effects-of-modified-continuous-intercostal-block-and-paravertebral-block-under-surgeon-s-direct-vision-after-video-assisted-thoracic-surgery-a-randomized-clinical-trial
#13
Yuka Kadomatsu, Shoichi Mori, Harushi Ueno, Mika Uchiyama, Kenji Wakai
OBJECTIVE: Clinical evidence comparing paravertebral (PVB) and continuous intercostal nerve (ICB) blocks for pain management post video-assisted thoracic surgery (VATS) is limited. This study confirms the analgesic effect of ICB using two catheters is not inferior to that of PVB under direct vision. METHODS: Fifty patients who underwent VATS lobectomy from July 2015 to March 2016 were prospectively recruited and randomly assigned to PVB and ICB groups. Postoperative pain was assessed using the visual analog scale (VAS)...
May 8, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29730268/thoracic-paravertebral-block-versus-thoracic-epidural-analgesia-for-post-operative-pain-control-in-open-pancreatic-surgery-a-randomized-controlled-trial
#14
Jacob L Hutchins, Anthony J Grandelis, Alexander M Kaizer, Eric H Jensen
STUDY OBJECTIVE: The purpose of this study was to compare the efficacy of bilateral ultrasound guided thoracic paravertebral catheters to a thoracic epidural after open pancreatic surgery. DESIGN: This was a prospective non-blinded randomized controlled trial. SETTING: Academic hospital operating room, postoperative recovery area, and ward. PATIENTS: 53 patients aged 18 and above who had open pancreatic surgery. INTERVENTIONS: Patients received either bilateral thoracic paravertebral block at T8 with an infusion of 0...
May 3, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29720754/effects-of-adding-dexamethasone-or-ketamine-to-bupivacaine-for-ultrasound-guided-thoracic-paravertebral-block-in-patients-undergoing-modified-radical-mastectomy-a-prospective-randomized-controlled-study
#15
Mona Blough El Mourad, Asmaa Fawzy Amer
Background and Aims: Pain after modified radical mastectomy (MRM) has been successfully managed with thoracic paravertebral block (TPVB). The purpose of this study was to evaluate the effect of adding dexamethasone or ketamine as adjuncts to bupivacaine in TPVB on the quality of postoperative analgesia in participants undergoing MRM. Methods: This prospective randomised controlled study enrolled ninety adult females scheduled for MRM. Patients were randomised into three groups (30 each) to receive ultrasound-guided TPVB before induction of general anaesthesia...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29714650/real-time-view-of-anesthetic-solution-spread-during-an-ultrasound-guided-thoracic-paravertebral-block
#16
Domenico P Santonastaso, Annabella de Chiara, Marco Rispoli, Giovanni Musetti, Vanni Agnoletti
BACKGROUND: Thoracic paravertebral block is a technique for perioperative analgesia in patients undergoing thoracic, chest wall, or breast surgery, or for pain management with rib fractures, which can be performed with or without ultrasound guidance. The ultrasound guidance technique can be used to identify the thoracic paravertebral space, guide needle placement, monitor the spread of local anesthetic (LA) solution, and reduce complications such as pleural puncture and pneumothorax. The possibility of assessing anesthetic spread in real time using ultrasound guidance during paravertebral block offers numerous advantages, including the immediate and accurate identification of the extent of nervous block, with a consequent reduction of LA dose...
March 1, 2018: Tumori
https://www.readbyqxmd.com/read/29708919/the-use-of-liposomal-bupivacaine-in-erector-spinae-plane-block-to-minimize-opioid-consumption-for-breast-surgery-a-case-report
#17
Amanda Kumar, Alina Hulsey, Hector Martinez-Wilson, James Kim, Jeff Gadsden
The erector spinae plane block is a novel interfascial plane block that can provide thoracic and abdominal analgesia. We describe a patient with opioid intolerance scheduled for breast surgery who received an erector spinae plane block with liposomal bupivacaine as well as a supplemental T1 paravertebral block resulting in profound analgesia throughout her postoperative course. This case report demonstrates that use of liposomal bupivacaine in the erector spinae plane block can be successful in providing extended duration postoperative analgesia and minimizing systemic opioid requirements...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29707356/the-role-of-local-anaesthetic-techniques-in-eras-protocols-for-thoracic-surgery
#18
REVIEW
Seamus Crumley, Stefan Schraag
The use of enhanced recovery after surgery (ERAS), as in other surgical specialties, is an emerging concept in cardio-thoracic surgery but there is still a lack of effective protocols to reduce the burden of surgery on the patient, shorten the period of postoperative recovery, and reduce the likelihood of chronic pain developing. The use of local anaesthetic (LA) techniques, such as thoracic epidural analgesia (TEA) and paravertebral blocks (PVB), as an adjunct to anaesthesia are considered key components, though there is little data for direct comparison of the techniques...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29702487/percutaneous-radiofrequency-ablation-of-pulmonary-metastasis-and-thoracic-paravertebral-block-under-computed-tomographic-scan-guidance-a-case-report
#19
Laura Ruscio, Olivier Planche, Paul Zetlaoui, Dan Benhamou
Pain during and after pulmonary percutaneous radiofrequency ablation (RFA) may be severe enough to require opioids. Thoracic paravertebral block (TPVB) is a regional anesthetic technique that can relieve pain during and after abdominal or thoracic painful procedures. We report the use of TPVB to relieve postprocedural pain in a 50-year-old woman after RFA of lung metastasis. The TPVB was performed under computed tomographic guidance by the anesthesiologist. The patient was pain free (rest and mobilization) during the first postoperative 36 hours...
April 26, 2018: A&A practice
https://www.readbyqxmd.com/read/29629202/enhanced-recovery-pathways-in-thoracic-surgery-from-italian-vats-group-perioperative-analgesia-protocols
#20
REVIEW
Federico Piccioni, Matteo Segat, Stefano Falini, Marzia Umari, Olga Putina, Lucio Cavaliere, Riccardo Ragazzi, Domenico Massullo, Marco Taurchini, Carlo Del Naja, Andrea Droghetti
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies...
March 2018: Journal of Thoracic Disease
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