Read by QxMD icon Read

Thoracic paravertebral block

Ashutosh Sahu, Rajnish Kumar, Mumtaz Hussain, Ajit Gupta, K H Raghwendra
BACKGROUND: Regional anesthesia using paravertebral block has been suggested as an ideal adjunct to general anesthesia for modified radical mastectomy. Paravertebral block is an effective management of peri-operative pain for Modified radical mastectomy, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. AIM: To evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine)...
September 2016: Anesthesia, Essays and Researches
S D Adhikary, K El-Boghdadly, Z Nasralah, N Sarwani, A M Nixon, K J Chin
We performed bilateral transmuscular quadratus lumborum blocks in six cadavers using iodinated contrast and methylene blue. Computed tomography imaging was performed in four cadavers and anatomical dissection was completed in five. This demonstrated spread to the lumbar paravertebral space in 63% of specimens, laterally to the transversus abdominis muscle in 50% and caudally to the anterior superior iliac spine in 63% of specimens. There was no radiographic evidence of spread to the thoracic paravertebral space...
October 12, 2016: Anaesthesia
Diab Fuad Hetta, Khalid Mohammed Rezk
STUDY OBJECTIVE: The aim of this study was to evaluate the analgesic efficacy and safety of pectoralis-serratus interfascial plane block in comparison with thoracic paravertebral block for postmastectomy pain. DESIGN: A prospective randomized controlled study. SETTING: Tertiary center, university hospital. PATIENTS: Sixty-four adult women, American Society of Anesthesiologists physical status classes I, II, and III, scheduled for unilateral modified radical mastectomy with axillary evacuation...
November 2016: Journal of Clinical Anesthesia
Yeon-Dong Kim, Seon-Jeong Park, Junho Shim, Hyungtae Kim
The recently introduced pectoral nerve (Pecs) block is a simple alterative to the conventional thoracic paravertebral block or epidural block for breast surgery. It produces excellent analgesia and can be used to provide balanced anesthesia and as a rescue block in cases where performing a neuraxial blockade is not possible. In the thoracic region, a neuraxial blockade is often used to manage zoster-associated pain. However, this can be challenging for physicians due to the increased risk of hemodynamic instability in the upper thoracic level, and comorbid and contraindicated medical conditions such as coagulopathy...
September 20, 2016: Journal of Anesthesia
A M-H Ho, M K Karmakar, S K Ng, S Wan, C S H Ng, R H L Wong, S K C Chan, G M Joynt
We conducted a small pilot observational study of the effects of bilateral thoracic paravertebral block (BTPB) as an adjunct to perioperative analgesia in coronary artery bypass surgery patients. The initial ropivacaine dose prior to induction of general anaesthesia was 3 mg/kg, which was followed at the end of the surgery by infusion of ropivacaine 0.25% 0.1 ml/kg/hour on each side (e.g. total 35 mg/hour for a 70 kg person). The BTPB did not eliminate the need for supplemental opioids after CABG in the eight patients studied...
September 2016: Anaesthesia and Intensive Care
Hideaki Kojima, Mitsuhiro Isaka, Yoshiyuki Yasuura, Reiko Shimizu, Hiroyuki Kayata, Shoji Takahashi, Eiji Ando, Yasuhisa Ohde
We retrospectively assessed the effectiveness and the safety of thoracic paravertebral block(PVB) in patients ineligible for epidural block (EP). Eleven PVB patients and 33 EP patients were enrolled. Postoperative pain was evaluated using a numerical rating scale (NRS). The mean NRS ± standard deviation at rest 24 and 48 hours after surgery were 1.36 ± 1.63 and 0.55 ± 1.03 in the PVB group and 1.07 ± 1.47 and 1.38 ± 1.31 in the EP group, respectively. There were no statistically significant differences in the NRS scores...
September 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kenta Okitsu, Takeshi Iritakenishi, Mitsuo Iwasaki, Tatsuyuki Imada, Yuji Fujino
OBJECTIVE: This study aimed to determine the risk of hematoma associated with thoracic paravertebral block (TPVB) in patients undergoing cardiovascular surgery. DESIGN: Retrospective analysis. SETTING: Single university hospital. PARTICIPANTS: The study comprised 141 patients who underwent cardiovascular surgery with TPVB to relieve postoperative pain. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Three patients were excluded and of the remaining 138, TPVB was performed in 135, ages 11 to 96 years, who either had a clotting abnormality or were on anticoagulant or antiplatelet therapy...
June 3, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Rajesh Kasimahanti, Suman Arora, Nidhi Bhatia, Gurpreet Singh
OBJECTIVES: Thoracic paravertebral block (TPVB) for breast surgery reduces acute and chronic postoperative pain. Using ultrasound for administering the block makes it easier, with its administration at multiple levels decreasing the number of unblocked segments. We conducted this study to evaluate the efficacy and safety of single- vs double-level ultrasound-guided TPVB in patients undergoing total mastectomy with axillary clearance under general anesthesia. DESIGN: This is a prospective, randomized study...
September 2016: Journal of Clinical Anesthesia
Gloria S Cheng, Brian M Ilfeld
OBJECTIVE: To review the published evidence regarding perioperative analgesic techniques for breast cancer-related surgery. DESIGN: Topical review. METHODS: Randomized, controlled trials (RCTs) were selected for inclusion in the review. Also included were large prospective series providing estimates of potential risks and technical reports and small case series demonstrating a new technique or approaches of interest to clinicians. RESULTS: A total of 514 abstracts were reviewed, with 284 studies meeting criteria for full review...
August 22, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
S Kulhari, N Bharti, I Bala, S Arora, G Singh
BACKGROUND: Pectoral nerve (PecS) block is a recently introduced technique for providing surgical anaesthesia and postoperative analgesia during breast surgery. The present study was planned to compare the efficacy and safety of ultrasound-guided PecS II block with thoracic paravertebral block (TPVB) for postoperative analgesia after modified radical mastectomy. METHODS: Forty adult female patients undergoing radical mastectomy were randomly allocated into two groups...
September 2016: British Journal of Anaesthesia
K El-Boghdadly, C Madjdpour, K J Chin
Thoracic paravertebral blocks (TPVBs) have an extensive evidence base as part of a multimodal analgesic strategy for thoracic and breast surgery and have gained popularity with the advent of ultrasound guidance. However, this role is poorly defined in the context of abdominal surgery. We performed a systematic review of randomized controlled trials, to clarify the impact of TPVB on perioperative analgesic outcomes in adult abdominal surgery. We identified 20 published trials involving a total of 1044 patients that met inclusion criteria; however there was significant heterogeneity in terms of type of surgery, TPVB technique, comparator groups and study quality...
September 2016: British Journal of Anaesthesia
Samuel M Galvagno, Charles E Smith, Albert J Varon, Erik A Hasenboehler, Shahnaz Sultan, Gregory Shaefer, Kathleen B To, Adam Fox, Darrell E R Alley, Michael Ditillo, Bellal A Joseph, Bryce R H Robinson, Elliot Haut
INTRODUCTION: Thoracic trauma is the second most prevalent non-intentional injury in the United States, and is associated with significant morbidity. Analgesia for blunt thoracic trauma was first addressed by the Eastern Association for the Surgery of Trauma (EAST) with a practice management guideline published in 2005. Since that time, it was hypothesized that there have been advances in the analgesic management for blunt thoracic trauma. As a result, updated guidelines for this topic using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework recently adopted by EAST are presented...
August 16, 2016: Journal of Trauma and Acute Care Surgery
Takeshi Murouchi, Michiaki Yamakage
PURPOSE: Retrolaminar block (RLB) is a thoracic truncal block that can produce analgesia for the thoracic and abdominal wall. However, the characteristics of RLB are not well known. The aim of this study was to determine analgesic efficacy by measuring postoperative consume of patient-controlled analgesia (PCA), additional nonsteroidal antiinflammatory drug (NSAID) rescue, and opioid rescue. Our secondary analysis included assessment of the chronological change in arterial levobupivacaine concentrations after the block...
August 12, 2016: Journal of Anesthesia
Geoff Frawley, Jacinta Frawley, Joe Crameri
BACKGROUND: Pectus excavatum (PE) is the most common congenital chest wall deformity, occurring in 1 : 1000 children with a male to female ratio of 4 : 1. Several procedures have been described to manage this deformity, including cartilage resection with sternal osteotomy (the Ravitch procedure) and a minimally invasive repair technique (the Nuss procedure). While initially described as a nonthoracoscopic technique, the current surgical approach of the Royal Childrens Hospital involves thoracoscopic assistance...
November 2016: Paediatric Anaesthesia
Kenta Okitsu, Takeshi Iritakenishi, Sho Carl Shibata, Keitaro Domae, Koichi Toda, Yoshiki Sawa, Yuji Fujino
Left ventricular assist device (LVAD) implantation is increasingly being used as a bridging therapy to heart transplantation. Infection is a major complication in patients with implanted LVADs, and it is associated with short- and long-term mortality. Surgical management for infection control is sometimes necessary; however, providing pain management during the surgical procedures is challenging. Anesthesiologists may be able to contribute to better pain management during surgical interventions to treat LVAD infections...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Yong Liu, Xiao Yu, Xingxing Sun, Qing Ling, Shaogang Wang, Jihong Liu, Ailin Luo, Yuke Tian, Wei Mei
BACKGROUND: Paravertebral block is often used to provide postoperative analgesia after renal surgery. In this case-series report, we present our experience with 3 patients in whom percutaneous nephrolithotomy was performed successfully under ultrasound-guided 3-segment lumbar-thoracic paravertebral block. CASE SUMMARY: Three patients were scheduled for percutaneous nephrolithotomy. All 3 patients were high-risk cases for both general and neuraxial anesthesia. After due deliberation and with the consent of patient and his family, ultrasound-guided paravertebral block was performed...
July 2016: Medicine (Baltimore)
Korgün Okmen, Burcu Metin Okmen, Serkan Uysal
Thoracotomy is a surgical technique used to reach the thoracic cavity. Management of pain due to thoracotomy is important in order to protect the operative respiratory reserves and decrease complications. For thoracotomy pain, blocks (such as thoracic epidural, paravertebral, etc.) and pleural catheterization and intravenous drugs (such as nonsteroidal anti-inflammatory drugs [NSAIDs], and opioids, etc., can be used. We performed a serratus anterior plane (SAP) block followed by catheterization for thoracotomy pain...
July 2016: Korean Journal of Pain
Pınar Kendigelen, Rahşan Özcan, Şenol Emre
No abstract text is available yet for this article.
February 2016: Turkish Journal of Anaesthesiology and Reanimation
Tasuku Fujii, Yasuyuki Shibata, Kimitoshi Nishiwaki
No abstract text is available yet for this article.
June 24, 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Trylon Mathew Tsang, Alfin Taddeo Okullo, Jeremy Field, Patrick Mamo
A 66-year-old man underwent a left minithoracotomy for pleural biopsies and thoracentesis. A left T3 paravertebral catheter was placed prior to induction of general anaesthesia, and a total of 20 mL of bupivacaine 0.25% administered. Postoperatively, ropivacaine 0.2% infusion was commenced at 10 mL/hour. Thirty-seven hours after the initial block, the patient developed convulsions without loss of consciousness. The ropivacaine infusion rate was unchanged and no further boluses had been given. He reported of perioral tingling, a burning sensation in his legs and penis and agitation...
2016: BMJ Case Reports
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"