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Paravertebral block

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https://www.readbyqxmd.com/read/29629202/enhanced-recovery-pathways-in-thoracic-surgery-from-italian-vats-group-perioperative-analgesia-protocols
#1
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
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#2
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29590739/gastrostomy-under-paravertebral-block-in-high-risk-patients-with-esophageal-cancer-two-case-reports
#3
Miroslav Zupčić, Anđelko Korušić, Stjepan Barišin, Jasminka Peršec, Igor Nikolić, Sandra Graf Zupčić, Vjekoslav Jeleč, Viktor Đuzel, Zlatko Vlajčić
Here we present two cases of gastrostomy insertion via laparotomy in patients with malignant esophageal disease. Patients were ASA (American Society of Anesthesiologists) physical status III and IV. The patients presented as very high risk for general anesthesia, so we decided to use unilateral left sided paravertebral block (PVB) on four thoracic levels along with contralateral local infiltration at the gastrostomy insertion site. We present two cases, one of them a 57-year-old male ASA III patient scheduled for a gastrostomy procedure due to esophageal cancer with infiltration of the trachea...
December 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29589423/ultrasound-guided-bilateral-thoracic-paravertebral-block-for-emergency-incisional-hernia-repair
#4
Domenico P Santonastaso, Annabella DE Chiara, Vanni Agnoletti
No abstract text is available yet for this article.
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29578176/applications-of-nerve-stimulator-guided-thoracic-paravertebral-nerve-block-plus-general-anesthesia-in-small-incision-lung-cancer-surgery
#5
Pengfei Lei, Shan Gao, Peishan Wang, Jiefang Fan, Xiting Ai
Objective: The aim of the study was to investigate the application of nerve stimulator-guided thoracic paravertebral nerve block (TPVB) plus general anesthesia (GA) in small-incision lung cancer surgery. Methods: Forty patients scheduled for small-incision lung cancer surgery, the American Society of Anesthesiologists Grade I-II, were randomized into a TPVB-GA group (Group P) and a GA group (Group G), with 20 cases in each group. The dosage of general anesthetic, mean arterial pressure (MAP) at each time point, and heart rate (HR) of the two groups were recorded...
2018: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/29577505/efficacy-and-safety-of-bilateral-thoracic-paravertebral-blocks-in-outpatient-breast-surgery
#6
Linden K Head, Anne Lui, Kirsty Usher Boyd
Unilateral thoracic paravertebral blocks (TPVBs) have demonstrated reliable intraoperative analgesia, low postoperative pain scores, and an opioid-sparing effect in breast cancer surgery. However, secondary to the perceived risk of complications, bilateral TPVB have been less well accepted and are less frequently used. The purpose of this study was to evaluate the feasibility of using bilateral TPVBs in outpatient surgery for patients undergoing bilateral mastectomy with immediate implant-based reconstruction...
March 25, 2018: Breast Journal
https://www.readbyqxmd.com/read/29576125/single-shot-pectoral-plane-pecs-i-and-pecs-ii-blocks-versus-continuous-local-anaesthetic-infusion-analgesia-or-both-after-non-ambulatory-breast-cancer-surgery-a-prospective-randomised-double-blind-trial
#7
P O'Scanaill, S Keane, V Wall, G Flood, D J Buggy
BACKGROUND: Pectoral plane blocks (PECs) are increasingly used in analgesia for patients undergoing breast surgery, and were recently found to be at least equivalent to single-shot paravertebral anaesthesia. However, there are no data comparing PECs with the popular practice of continuous local anaesthetic wound infusion (LA infusion) analgesia for breast surgery. Therefore, we compared the efficacy and safety of PECs blocks with LA infusion, or a combination of both in patients undergoing non-ambulatory breast-cancer surgery...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29528863/intraoperative-sedation-with-dexmedetomidine-is-superior-to-propofol-for-elderly-patients-undergoing-hip-arthroplasty-a-prospective-randomized-controlled-study
#8
Bin Mei, Gaige Meng, Guanghong Xu, Xinqi Cheng, Shishou Chen, Ye Zhang, Ming Zhang, Xuesheng Liu, Erwei Gu
BACKGROUND: Peripheral nerve block is a preferable method for elderly patients receiving hip arthroplasty. Sedation with dexmedetomidine may reduce postoperative delirium. The aim of this study was to investigate whether intraoperative sedation with dexmedetomidine, as a supplementary to peripheral nerve block for elderly patients receiving total hip arthroplasty, can decrease the prevalence of postoperative delirium. METHODS: A prospective, randomized controlled study was conducted with patients 65 years of age or older who underwent total hip arthroplasty between June 2016 and June 2017...
March 9, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29512813/evaluation-of-the-effectiveness-of-the-quadratus-lumborum-block-type-i-using-ropivacaine-in-postoperative-analgesia-after-a-cesarean-section-a-controlled-clinical-study
#9
Marcin Mieszko Mieszkowski, Ewa Mayzner-Zawadzka, Bułat Tuyakov, Marta Mieszkowska, Maciej Żukowski, Tomasz Waśniewski, Dariusz Onichimowski
OBJECTIVES: Quadratus Lumborum Block in contrast to Transversus Abdominis Plane Block contains a unique component which not only stops somatic pain but also inhibits visceral pain by spreading the local anesthetic to the paravertebral space. This study was designed to determine whether performing the Quadratus Lumborum Block type I in patients un-dergoing cesarean section would be associated with both decreased morphine consumption and decreased pain levels in the postoperative 48-hour period...
2018: Ginekologia Polska
https://www.readbyqxmd.com/read/29491521/erector-spinae-plane-block-may-aid-weaning-from-mechanical-ventilation-in-patients-with-multiple-rib-fractures-case-report-of-two-cases
#10
Amar Nandhakumar, Amritha Nair, V Kiran Bharath, Sriraam Kalingarayar, Balaji P Ramaswamy, D Dhatchinamoorthi
Uncontrolled pain in patients with rib fracture leads to atelectasis and impaired cough which can progress to pneumonia and respiratory failure necessitating mechanical ventilation. Of the various pain modalities, regional anaesthesia (epidural and paravertebral) is better than systemic and oral analgesics. The erector spinae plane block (ESPB) is a new modality in the armamentarium for the management of pain in multiple rib fractures, which is simple to perform and without major complications. We report a case series where ESPB helped in weaning the patients from mechanical ventilation...
February 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29462058/comparison-of-paravertebral-block-by-anatomic-landmark-technique-to-ultrasound-guided-paravertebral-block-for-breast-surgery-anesthesia-a-randomized-controlled-trial
#11
Rupali Patnaik, Anjolie Chhabra, Rajeshwari Subramaniam, Mahesh K Arora, Devalina Goswami, Anurag Srivastava, Vuthaluru Seenu, Anita Dhar
BACKGROUND AND OBJECTIVES: Paravertebral block (PVB) is an established technique for providing anesthesia for breast surgery. The primary objective was to compare anatomical landmark technique (ALT) to the ultrasound-guided (USG) PVB block for providing surgical anesthesia. Secondary objectives included comparison of perioperative analgesia and complications. METHODS: This randomized, controlled, observer-blinded study included 72 females, aged 18 to 65 years, American Society of Anesthesiologists physical status I or II, undergoing elective unilateral breast surgery...
February 16, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29457120/spread-of-injectate-in-ultrasound-guided-serratus-plane-block-a-cadaveric-study
#12
Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage
Background: Serratus plane block is a thoracic truncal block that has been proposed as alternatives for analgesia such as epidural anesthesia and paravertebral block for the anterolateral chest wall. Previously, we performed the clinical study about optimal volume of the local anesthetic in serratus plane block. The primary aim of this study was to assess the pattern of distribution of dye into the serratus plane of cadavers after ultrasound-guided serratus plane injection. Findings: Ultrasound-guided serratus plane injection was performed at the level of the fourth rib on the mid-axillary line in nine adult Thiel-embalmed cadavers...
2018: JA clinical reports
https://www.readbyqxmd.com/read/29454333/comparative-study-of-ultrasound-guided-paravertebral-block-versus-intravenous-tramadol-for-postoperative-pain-control-in-percutaneous-nephrolithotomy
#13
Zehra Hatipoglu, Ersel Gulec, Mediha Turktan, Volkan Izol, Atilla Arıdogan, Yasemin Gunes, Dilek Ozcengiz
BACKGROUND: Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for renal calculi, and nephrostomy tubes lead to postoperative pain after PCNL. Regional techniques (e.g., epidural analgesia and peripheral blocks) and opioids are applied for postoperative pain treatment. The aim of this study was to compare effectiveness of ultrasound-guided paravertebral block (PVB) and tramadol on postoperative pain in patients who underwent PCNL. METHOD: Fifty-three patients were included in this prospective randomized study...
February 17, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29445296/the-ultrasound-guided-retrolaminar-block-volume-dependent-injectate-distribution
#14
Marija Damjanovska, Tatjana Stopar Pintaric, Erika Cvetko, Kamen Vlassakov
Purpose: The ultrasound-guided retrolaminar block is one of the newer and simpler alternatives to the traditional, often technically challenging, paravertebral (PV) block. Its feasibility, safety, and efficacy have already been clinically demonstrated in patients with multiple rib fractures using higher volumes of local anesthetic, when compared with the traditional approach. The primary aim of this observational anatomical study was to assess the spread of local anesthetic from the retrolaminar injection point to the PV space and its volume dependence...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29433996/gelatin-thoracic-paravertebral-teaching-model-for-placement-of-a-continuous-infusion-catheter-in-the-extrathoracic-paravertebral-space
#15
Shruti Sevak, Ashley Woodfin, Zachary Hothem, Rose Callahan, James Robbins, Kathryn Ziegler
OBJECTIVE: Our aim was to develop an ultrasound-guided training curriculum for continuous infusion catheter placement in the paravertebral space and to create a gelatin thoracic spine-rib model for use in this training. We sought to create a model that was inexpensive and reusable such that multiple participants could use one model during training. DESIGN: The model was prepared by embedding a firm foam thoracic spine replica with bilateral attached ribs into an opaque gelatin mixture...
February 9, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29416465/opioid-sparing-effects-of-the-thoracic-interfascial-plane-blocks-a-meta-analysis-of-randomized-controlled-trials
#16
REVIEW
Preet Mohinder Singh, Anuradha Borle, Manpreet Kaur, Anjan Trikha, Ashish Sinha
Background: Thoracic interfascial plane blocks and modification (PECS) have recently gained popularity for analgesic potential during breast surgery. We evaluate/consolidate the evidence on opioid-sparing effect of PECS blocks in comparison with conventional intravenous analgesia (IVA) and paravertebral block (PVB). Materials and Methods: Prospective, randomized controlled trials comparing PECS block to conventional IVA or PVB in patients undergoing breast surgery published till June 2017 were searched in the medical database...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416456/evaluation-of-safety-and-efficacy-of-regional-anesthesia-compared-with-general-anesthesia-in-thoracoscopic-lung-biopsy-procedure-on-patient-with-idiopathic-pulmonary-fibrosis
#17
Waseem M Hajjar, Sami A Al-Nassar, Ghaida S Al-Sugair, Alaa Al-Oqail, Shahd Al-Mansour, Rand Al-Haweel, Adnan W Hajjar
Background: Interstitial lung diseases are diseases that need histology diagnosis or obtaining a lung biopsy to establish the diagnosis. Surgical biopsies are performed usually using the thoracoscopy technique under general anesthesia (GA) although this procedure is still associated with morbidity rate. The aim of this study is to determine the effectiveness and safety of regional anesthesia (RA) compared with GA in thoracoscopic lung biopsy procedures done on patients with idiopathic pulmonary fibrosis (IPF)...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29411633/harlequin-syndrome-following-upper-lobectomy
#18
Nabil Hussein, Yama Haqzad, Joshil Lodhia, Sofina Begum, Michael Cowen
A 58-year-old women developed unilateral facial flushing and sweating on the left side of her face immediately after a right thoracotomy upper lobectomy and paravertebral block. She was diagnosed with Harlequin syndrome in the absence of any other neurological signs or symptoms. She had recovered completely from this episode on follow-up.
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29411048/comparison-of-analgesic-interventions-for-traumatic-rib-fractures-a-systematic-review-and-meta-analysis
#19
Jesse Peek, Diederik P J Smeeing, Falco Hietbrink, Roderick M Houwert, Marije Marsman, Mirjam B de Jong
PURPOSE: Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks...
February 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29408967/effects-of-stellate-ganglion-block-on-analgesia-produced-by-cervical-paravertebral-block-as-established-by-quantitative-sensory-testing-a-randomized-controlled-trial
#20
Luc A Sermeus, Luc E Vanlinthout, Guy H Hans, Tom Schepens, Margaretha B Breebaart, Veerle C Verheyen, Carine J Smitz, Marcel P Vercauteren
Objective: To use quantitative sensory testing (QST) to assess whether a stellate ganglion block (SGB) modulates the analgesia induced by cervical paravertebral block (CPVB). Design: A prospective double-blind randomized controlled trial. Setting: Department of Anesthesia, Antwerp University Hospital, October 2011 to December 2015. Subjects: Twenty-eight adults scheduled for arthroscopy of a nonfractured shoulder were enrolled...
February 2, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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