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Paravertebral block

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https://www.readbyqxmd.com/read/28444433/boundaries-of-the-thoracic-paravertebral-space-potential-risks-and-benefits-of-the-thoracic-paravertebral-block-from-an-anatomical-perspective
#1
Esther A C Bouman, Judith M Sieben, Andrea J R Balthasar, Elbert A Joosten, Hans-Fritz Gramke, Maarten van Kleef, Arno Lataster
PURPOSE: Thoracic paravertebral block (TPVB) may be an alternative to thoracic epidural analgesia. A detailed knowledge of the anatomy of the TPV-space (TPVS), content and adnexa is essential in understanding the clinical consequences of TPVB. The exploration of the posterior TPVS accessibility in this study allows (1) determination of the anatomical boundaries, content and adnexa, (2) description of an ultrasound-guided spread of low and high viscous liquid. METHODS: In two formalin-fixed specimens, stratification of the several layers and the 3D-architecture of the TPVS were dissected, observed and photographed...
April 25, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28413293/in-response-to-comparison-of-paravertebral-and-interpleural-block-in-patients-undergoing-modified-radical-mastectomy
#2
Souvik Maitra, Dalim Kumar Baidya, Sulagna Bhattacharjee
No abstract text is available yet for this article.
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28387892/anesthesia-and-analgesia-in-breast-surgery-the-benefits-of-peripheral-nerve-block
#3
L Calì Cassi, F Biffoli, D Francesconi, G Petrella, O Buonomo
Breast surgery is frequently associated with postoperative pain, nausea and vomiting, that result in increased patient's suffering, prolongation of hospital stays and related costs. Thoracic paravertebral nerve block (TPVB) is a viable option to the classic multimodal analgesia in breast surgery as it enhances surgical anesthesia and postoperative analgesia. In this review, we report the results of a number of studies on the role of TPVB in breast surgery. This technique is associated with a superior control of the pain, a reduction in opioids consumption after surgery, a decrease in postoperative nausea and vomiting, and an overall decrease in length of hospital stay...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28364165/post-mastectomy-cancer-recurrence-with-and-without-a-continuous-paravertebral-block-in-the-immediate-postoperative-period-a-prospective-multi-year-follow-up-pilot-study-of-a-randomized-triple-masked-placebo-controlled-investigation
#4
Daphna M Finn, Brian M Ilfeld, Jonathan T Unkart, Sarah J Madison, Preetham J Suresh, Nav Parkash S Sandhu, Nicholas J Kormylo, Nisha Malhotra, Vanessa J Loland, Mark S Wallace, Cindy H Wen, Anya C Morgan, Anne M Wallace
PURPOSE: Retrospective studies have associated perioperative regional anesthesia/analgesia during mastectomy for breast cancer with a decreased incidence of cancer recurrence. However, to date, no prospective data from a randomized controlled trial have been reported. In a previous study we found that extending a single-injection paravertebral block with a multiple-day perineural local anesthetic infusion improves analgesia. This follow-up study investigates the rates of cancer recurrence for the single-injection and multiple-day infusion treatments...
March 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28339431/perioperative-ketamine-administration-for-thoracotomy-pain
#5
Daniel W Moyse, Alan D Kaye, James H Diaz, Muhammad Y Qadri, David Lindsay, Srinivas Pyati
BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28323571/lymphatic-drainage-to-the-paravertebral-lymph-nodes-in-breast-cancer-patients
#6
Mirela Mariana Roman, Romain Barbieux, Olivier Leduc, Pierre Bourgeois
INTRODUCTION: Aberrant, altered, or blocked lymphatic drainage may contribute to the high recurrence rate of breast cancer. Thus, an efficient evaluation of lymphatic drainage from the breasts and/or upper limbs is essential in the management of lymphedema and in ipsilateral primary or contralateral recurrent breast cancer patients. There are very few reports of lymphatic drainage to the paravertebral lymph nodes in patients with a lymphedema after breast cancer surgery with or without reconstruction...
March 2017: Lymphatic Research and Biology
https://www.readbyqxmd.com/read/28306584/serratus-anterior-plane-block-to-address-post-thoracotomy-and-chest-tube-related-pain-a-report-on-3-cases
#7
George M Chu, G Craig Jarvis
In this case report, the serratus anterior plane block was used in conjunction with multilevel continuous thoracic paravertebral blocks (TPVB) and general anesthesia in 3 thoracotomy cases. All blocks were accompanied by use of catheters that allowed continuous local anesthetic infusions and intermittent local anesthetic bolus injections to address postoperative pain. In all 3 patients, the serratus anterior plane block provided analgesia for chest tube-related pain that was not provided by the TPVB alone.
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28292551/the-effect-of-paravertebral-block-on-maxillofacial-free-flap-survival
#8
A M A Habib, O M Zanaty, H F Anwer, D Abo Alia
The purpose of this study was to investigate whether continuous paravertebral block at levels T1 and T2 with bupivacaine infusion can improve the survival of free flaps in maxillofacial reconstruction. The study was designed as a randomized controlled trial and included 36 adult patients scheduled for maxillofacial free flap reconstruction under general anesthesia. Patients were randomly divided into two groups: patients in group A received continuous paravertebral block at levels T1 and T2, while patients in group B served as controls...
March 11, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28277325/the-pathway-of-injectate-spread-with-the-transmuscular-quadratus-lumborum-block-a-cadaver-study
#9
Mette Dam, Bernhard Moriggl, Christian K Hansen, Romed Hoermann, Thomas F Bendtsen, Jens Børglum
BACKGROUND: The spread of injectate resulting from a transmuscular quadratus lumborum (TQL) block and a transverse oblique paramedian (TOP) TQL block has never been examined. The aim of this cadaveric study was to investigate by which pathway the injectate spreads cephalad into the thoracic paravertebral space and which nerves were dyed by the injectate cephalad and caudad to the diaphragm when performing a TQL and a TOP TQL block. We also aimed to investigate whether the thoracic and lumbar sympathetic trunks as well as the lumbar plexus were covered by the injectate...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28272292/the-erector-spinae-plane-block-provides-visceral-abdominal-analgesia-in-bariatric-surgery-a-report-of-3-cases
#10
Ki Jinn Chin, Laith Malhas, Anahi Perlas
Postoperative pain after bariatric surgery can be significant and yet difficult to manage. These patients frequently have associated obstructive sleep apnea and are at risk of respiratory depression with opioid analgesia. Abdominal wall blocks such as the subcostal transversus abdominis plane block are not of significant benefit, probably in part because they provide only somatic analgesia. The ultrasound-guided erector spinae plane (ESP) block is a recently described regional anesthetic technique for providing thoracic analgesia when performed at the level of the T5 transverse process...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28272291/review-of-sympathetic-blocks-anatomy-sonoanatomy-evidence-and-techniques
#11
Samir Baig, Jee Youn Moon, Hariharan Shankar
The autonomic nervous system is composed of the sympathetic and parasympathetic nervous systems. The sympathetic nervous system is implicated in situations involving emergent action by the body and additionally plays a role in mediating pain states and pathologies in the body. Painful conditions thought to have a sympathetically mediated component may respond to blockade of the corresponding sympathetic fibers. The paravertebral sympathetic chain has been targeted for various painful conditions. Although initially injected using landmark-based techniques, fluoroscopy and more recently ultrasound imaging have allowed greater visualization and facilitated injections of these structures...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28250491/ultrasound-guided-paravertebral-block-a-valuable-armamentarium-for-post-operative-pain-management
#12
Sumitra G Bakshi, Nupur Karan
No abstract text is available yet for this article.
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28235492/anesthesia-management-with-ultrasound-guided-thoracic-paravertebral-block-for-donor-nephrectomy-a-prospective-randomized-study
#13
Ozlem Yenidünya, Huseyin Yuce Bircan, Dilek Altun, Ismail Caymaz, Alp Demirag, Ayda Turkoz
STUDY OBJECTIVE: To determine the efficacy of ultrasound-guided thoracic paravertebral block intraoperatively and 24 hours postoperatively in patients undergoing donor nephrectomy. DESIGN: Prospective randomized controlled study. SETTING: Private foundation university hospital; November 2014 to June 2015. PATIENTS: Thirty-two patients undergoing donor nephrectomy (exclusion criteria: coagulation disorders, allergy to local anesthetics, and unwillingness to participate)...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28219848/bioelectronic-neuromodulation-of-the-paravertebral-cardiac-efferent-sympathetic-outflow-and-its-effect-on-ventricular-electrical-indices
#14
Una Buckley, Ray W Chui, Pradeep S Rajendran, Tina Vrabec, Kalyanam Shivkumar, Jeffrey L Ardell
BACKGROUND: Neuromodulation of the paravertebral ganglia by using symmetric voltage controlled kilohertz frequency alternating current (KHFAC) has the potential to be a reversible alternative to surgical intervention in patients with refractory ventricular arrhythmias. KHFAC creates scalable focal inhibition of action potential conduction. OBJECTIVE: The purpose of this article was to evaluate the efficacy of KHFAC when applied to the T1-T2 paravertebral chain to mitigate sympathetic outflow to the heart...
February 20, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28219590/continuous-paravertebral-infusions-as-an-effective-adjunct-for-postoperative-pain-management-in-living-liver-donors-a-retrospective-observational-study
#15
K Mistry, J Hutchins, J Leiting, K Mangalick, T Pruett, S Chinnakotla
We analyzed the effectiveness of paravertebral-block for immediate postoperative pain control in living liver donors. Specifically, we sought to determine whether or not the addition of paravertebral catheters with continuous ropivacaine infusion would decrease postoperative opioid use and reduce the incidence of adverse effects and complications. We reviewed the records of 26 patients who underwent right-lobe living donor hepatectomy (RLDH): 16 with and 10 without such catheters. The primary outcome was opioid use on postoperative day (POD) 1 through 3...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28217050/acoustic-puncture-assist-device%C3%A2-versus-conventional-loss-of-resistance-technique-for-thoracic-paravertebral-space-identification-clinical-and-ultrasound-evaluation
#16
Monaz Abdulrahman Ali, Ashraf Abualhasan Abdellatif
BACKGROUND: Acoustic puncture assist device (APAD™) is a pressure measurement combined with a related acoustic signal that has been successfully used to facilitate epidural punctures. The principal of loss of resistance (LOR) is similar when performing paravertebral block (PVB). We investigated the usefulness of APAD™ by comparing it with the conventional LOR techniques for identifying paravertebral space (PVS). SUBJECTS AND METHODS: A total of 100 women who were scheduled for elective breast surgery under general anesthesia with PVB were randomized into two equal groups...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28208979/evaluation-of-the-efficacy-of-bupivacaine-0-5-alone-or-with-clonidine-1%C3%AE-g-kg-versus-control-in-a-single-level-paravertebral-blockin-patients-undergoing-pcnl-procedure
#17
Trupti S Kamble, Charulata Mahesh Deshpande
INTRODUCTION: Percutaneous Nephrolithotomy (PCNL) is a widely used procedure to remove complex upper tract renal calculi by means of a nephroscope. Although less invasive, PCNL is associated with significant pain owing to soft tissue injury. Most of these patients have mild to moderately compromised renal function. An anaesthesia plan that reduces intraoperative requirement of anaesthetics, analgesics, muscle relaxants and postoperative requirement of systemic analgesics is essential...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203022/-clinical-evaluation-of-in-plane-ultrasound-guided-thoracic-paravertebral-block-using-laterally-intercostal-approach
#18
T Xu, M Li, Y Tian, J T Song, C Ni, X Y Guo
OBJECTIVE: To evaluate the feasibility and success rate of in-plane ultrasound-guided paravertebral block using laterally intercostal approach. METHODS: In the study, 27 patients undergoing elective thoracic surgery were selected to do paravertebral block preoperatively. The fifth intercostal space was scanned by ultrasound probe which was placed along the long axis of the rib and 8 cm lateral to the midline of the spine. The needle was advanced in increments aiming at the space between the internal and innermost intercostal muscles...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28181346/comparison-of-caudal-ropivacaine-morphine-and-paravertebral-catheter-for-major-upper-abdominal-surgery-in-infants
#19
Makoto Sato, Takafumi Iida, Chika Kikuchi, Tomoki Sasakawa, Takayuki Kunisawa
BACKGROUND: The caudal epidural block is one of the most commonly used regional anesthetic techniques in children. Administration of morphine via caudal injection enables analgesia, even for upper abdominal surgery. The thoracic paravertebral block has also been successfully used to treat perioperative pain during upper abdominal procedures in pediatric patients. AIM: In the current study, we compared the two regional techniques for upper abdominal surgery in infants to determine whether one of them was preferable to the other...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28122571/continuous-paravertebral-block-using-a-thoracoscopic-catheter-insertion-technique-for-postoperative-pain-after-thoracotomy-a-retrospective-case-control-study
#20
Yoshikane Yamauchi, Mitsuhiro Isaka, Kamon Ando, Keita Mori, Hideaki Kojima, Tomohiro Maniwa, Shoji Takahashi, Eiji Ando, Yasuhisa Ohde
BACKGROUND: Thoracic epidural analgesia (EDA) is the gold standard for pain control after thoracotomy. However, because of its severe side effects, it is contraindicated in patients taking anticoagulant or antiplatelet drugs. In addition, some patients' anatomy can make epidural catheter insertion challenging. We therefore investigated the safety and efficacy of paravertebral block (PVB) using a thoracoscopic insertion technique, which avoids damage to the parietal pleura, for postoperative pain after thoracotomy...
January 25, 2017: Journal of Cardiothoracic Surgery
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