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Paravertebral nerve block

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https://www.readbyqxmd.com/read/27870742/thoracic-paravertebral-nerve-blocks-in-pediatric-patients-safety-and-clinical-experience
#1
Tricia Vecchione, David Zurakowski, Karen Boretsky
Thoracic paravertebral nerve blocks (PVNBs) provide excellent analgesia for many surgeries. The primary aim was to estimate the complication rate, and secondary aims were to provide information on the potential clinical application of PVNBs. Data on 2390 PVNBs were collected. A total of 625 catheters were performed on 468 patients, and 1765 single-injection PVNBs were performed on 403 patients. There was 1 case of local anesthetic systemic toxicity for a major complication rate of 1 per 2390 PVNBs. The minor complication rate was 13...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27847703/treatment-of-post-latissimus-dorsi-flap-breast-reconstruction-pain-with-continuous-paravertebral-nerve-blocks-a-retrospective-review
#2
Jonathan T Unkart, Jennifer A Padwal, Brian M Ilfeld, Anne M Wallace
OBJECTIVES: The addition of a perioperative continuous paravertebral nerve block (cPVB) to a single-injection thoracic paravertebral nerve block (tPVB) has demonstrated improved analgesia in breast surgery. However, its use following isolated post-mastectomy reconstruction using a latissimus dorsi flap (LDF) has not previously been examined. METHODS: We performed a retrospective review of patients who underwent salvage breast reconstruction with a unilateral LDF by a single surgeon...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27830440/surgical-relevance-of-the-lateral-costotransverse-ligament-in-relation-to-the-dorsal-root-ganglion
#3
Anthony V D'Antoni, Peter G Collin, Rachel A Graham, Helena M Kennedy, Tatiana Ndjatou, Pamela Perez, R Shane Tubbs, Marios Loukas, Piotr B Kozlowski, Estomith P Mtui
The lateral costotransverse ligament, a short band that stabilizes the costovertebral joint, is found in close proximity to the dorsal root ganglion. This ligament is an important surgical landmark during tumor resections or nerve blocks in the paravertebral space. The purpose of this study was to quantitatively and qualitatively describe the morphology of the lateral costotransverse ligament and its relation to the dorsal root ganglion at all levels of the thoracic spine. The thoracic spines of eight embalmed cadavers were dissected bilaterally...
November 9, 2016: Anatomical Science International
https://www.readbyqxmd.com/read/27810148/introduction-of-a-novel-ultrasound-guided-extrathoracic-sub-paraspinal-block-for-control-of-perioperative-pain-in-nuss-procedure-patients
#4
Robert B Bryskin, Daniel K Robie, Frederick M Mansfield, Eugene B Freid, Siam Sukumvanich
BACKGROUND: A safe and effective method of multilevel thoracic pain control remains an elusive goal in patients undergoing the Nuss procedure. The aim of our study was to develop a nonopioid centered approach using a novel regional technique as part of a quality improvement initiative. METHODS: The proposed ultrasound-guided technique positions multi-perforated soaker catheter deep to the paraspinal muscles from T2 to T11. The project was conducted in two phases...
October 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27684866/transsacrococcygeal-approach-to-ganglion-impar-block-for-treatment-of-chronic-coccygodynia-after-spinal-arachnoid-cyst-removal-a-case-report
#5
Young Deog Cha, Chun Woo Yang, Jung Uk Han, Jang Ho Song, WonJu Na, Sora Oh, Byung-Gun Kim
BACKGROUND: Coccygodynia is a pain in the region of the coccyx that radiates to the sacral, perineal area. The cause of the pain is often unknown. Coccygodynia is diagnosed through the patient's past history, a physical examination, and dynamic radiographic study, but the injection of local anesthetics or a diagnostic nerve blockade are needed to distinguish between somatic, neuropathic, and combined pain. Ganglion impar is a single retroperitoneal structure made of both paravertebral sympathetic ganglions...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27676665/efficacy-and-safety-of-ketamine-added-to-local-anesthetic-in-modified-pectoral-block-for-management-of-postoperative-pain-in-patients-undergoing-modified-radical-mastectomy
#6
Ahmed H Othman, Ahmad M Abd El-Rahman, Fatma El Sherif
BACKGROUND: Breast surgery is an exceedingly common procedure with an increased incidence of acute and chronic pain. Pectoral nerve block is a novel peripheral nerve block alternative to neuro-axial and paravertebral blocks for ambulatory breast surgeries. OBJECTIVES: This study aims to compare the analgesic efficacy and safety of modified Pecs block with ketamine plus bupivacaine versus bupivacaine in patients undergoing breast cancer surgery. STUDY DESIGN: A randomized, double-blind, prospective study...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27650294/clinical-usefulness-of-pectoral-nerve-block-for-the-management-of-zoster-associated-pain-case-reports-and-technical-description
#7
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
https://www.readbyqxmd.com/read/27608346/local-anaesthetic-toxicity-after-bilateral-thoracic-paravertebral-block-in-patients-undergoing-coronary-artery-bypass-surgery
#8
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
https://www.readbyqxmd.com/read/27591461/paravertebral-block-for-management-of-acute-postoperative-pain-and-intercostobrachial-neuralgia-in-major-breast-surgery
#9
Mercedes Fernández Gacio, Ana Maria Agrelo Lousame, Susana Pereira, Clara Castro, Juliana Santos
BACKGROUND: Several locoregional techniques have been described for the management of acute and chronic pain after breast surgery. The optimal technique should be easy to perform, reproducible, with little discomfort to the patient, little complications, allowing good control of acute pain and a decreased incidence of chronic pain, namely intercostobrachial neuralgia for being the most frequent entity. OBJECTIVES: The aim of this study was to evaluate the paravertebral block with preoperative single needle prick for major breast surgery and assess initially the control of postoperative nausea and vomiting (PONV) and acute pain in the first 24h and secondly the incidence of neuropathic pain in the intercostobrachial nerve region six months after surgery...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27550949/an-evidence-based-review-of-the-efficacy-of-perioperative-analgesic-techniques-for-breast-cancer-related-surgery
#10
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
https://www.readbyqxmd.com/read/27546959/lower-limb-orthopedic-surgery-in-geriatric-patients-under-paravertebral-blocks-a-prospective-feasibility-study
#11
Rajesh Kumar Singh, J P Chaturvedi, H S Agrawal, Nitesh Agrawal
BACKGROUND: Aging causes progressive deterioration of all the organ systems. Physiological changes of aging and co-morbidities make regional anesthesia a preferred technique for this age group. Regional anesthesia with risk of hypotension and its consequences is fraught with dangers. Peripheral nerve blocks (PNBs) are much safer and give much superior post-op analgesia. The present study was undertaken to perform major lower limb orthopedic surgeries PNBs in geriatric settings. METHODS: A feasibility study was undertaken in patients above age of 60 years admitted for lower limb surgeries to undertake these surgeries under para-vertebral blocks for a period of one year from Mar 2011 to Feb 2012...
July 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27543533/efficacy-of-pectoral-nerve-block-versus-thoracic-paravertebral-block-for-postoperative-analgesia-after-radical-mastectomy-a-randomized-controlled-trial
#12
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
https://www.readbyqxmd.com/read/27533913/pain-management-for-blunt-thoracic-trauma-a-joint-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-and-trauma-anesthesiology-society
#13
Samuel Michael Galvagno, Charles E Smith, Albert J Varon, Erik A Hasenboehler, Shahnaz Sultan, Gregory Shaefer, Kathleen B To, Adam D Fox, Darrell E R Alley, Michael Ditillo, Bellal A Joseph, Bryce R H Robinson, Elliot R Haut
INTRODUCTION: Thoracic trauma is the second most prevalent nonintentional 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 GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework recently adopted by EAST are presented...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27510834/a-review-of-anesthetic-techniques-and-outcomes-following-minimally-invasive-repair-of-pectus-excavatum-nuss-procedure
#14
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
https://www.readbyqxmd.com/read/27440171/an-anatomical-evaluation-of-the-serratus-anterior-plane-block
#15
J Mayes, E Davison, P Panahi, D Patten, F Eljelani, J Womack, M Varma
The serratus anterior plane block has been described for analgesia of the hemithorax. This study was conducted to determine the spread of injectate and investigate the anatomical basis of the block. Ultrasound-guided serratus anterior plane block was performed on six soft-fix embalmed cadavers. All cadavers received bilateral injections, on one side performed with 20 ml latex and on the other with 20 ml methylene blue. Subsequent dissection explored the extent of spread and nerve involvement. Photographs were taken throughout dissection...
September 2016: Anaesthesia
https://www.readbyqxmd.com/read/27410754/-management-of-acute-postoperative-pain-following-thoracotomy-state-of-the-art
#16
J Matek, P Michálek, S Trča, Z Krška
UNLABELLED: Postoperative pain management is an important part of complex perioperative care in patients undergoing thoracotomy, irrespective of the procedure type. Adequate pain relief leads to early mobilisation, improves respiratory functions and decreases global stress response. Thus, good perioperative pain management significantly reduces postoperative complications. Currently, numerous analgesic methods are available for the management of acute postthoracotomy pain including patient- or nurse-controlled systemic administration of analgesics, infiltration with local anaesthetics, intrapleural or intercostal nerve blockades and neuroaxial blocks (paravertebral, intrathecal, epidural)...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27281726/epidural-versus-paravertebral-nerve-block-for-postoperative-analgesia-in-patients-undergoing-open-liver-resection-a-randomized-clinical-trial
#17
Kristin L Schreiber, Jacques E Chelly, R Scott Lang, Ezeldeen Abuelkasem, David A Geller, J Wallis Marsh, Allan Tsung, Tetsuro Sakai
BACKGROUND AND OBJECTIVES: Although many studies have found no difference between thoracic epidural block and unilateral thoracic paravertebral block after thoracotomy, no previous studies have compared epidural block with bilateral thoracic paravertebral block (bTPVB) in patients undergoing open liver resection. We aimed to investigate whether there was a significant analgesic advantage of thoracic epidural over bTPVB after liver resection. METHODS: This randomized, prospective, open-label study included adult patients undergoing elective open liver resection...
July 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27242357/continuous-paravertebral-block-for-post-cardiothoracic-surgery-analgesia-a-systematic-review-and-meta-analysis
#18
Anje J Scarfe, Susanne Schuhmann-Hingel, Joanna K Duncan, Ning Ma, Yasoba N Atukorale, Alun L Cameron
A continuous paravertebral block is used when pain relief is required beyond the duration of a single-injection paravertebral block. Surgical procedures requiring an incision into the pleural cavity are some of the most painful procedures postoperatively and, if not managed appropriately, can lead to chronic pain. The current gold standard for post-cardiothoracic surgery pain management is epidural analgesia, which has contraindications, a failure rate of up to 12% and risk of complications such as epidural abscess and spinal haematoma...
May 30, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27092398/intercostal-nerve-block-and-neurolysis-for-intractable-cancer-pain
#19
Gerald Matchett
Management of intractable cancer-associated chest wall pain is difficult once patients have reached dose-limiting side effects of opioids and coanalgesic medications. This case series describes 11 patients with intractable cancer-associated chest wall pain who were treated with a diagnostic intercostal nerve block. Six patients subsequently received chemical neurolysis with phenol using the same approach. No serious adverse events were observed. Radiopaque contrast dye spread into the paravertebral space in all 11 patients, and in 1 patient contrast dye spread into the epidural space...
June 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27043787/application-of-continuous-wound-infusion-catheters-in-lung-transplantation-a-retrospective-data-analysis
#20
Nils Lenz, Markus Hirschburger, Rainer Roehrig, Thilo Menges, Matthias Mueller, Winfried Padberg, Valesco Mann
Background Lung transplantation is the only treatment option for many patients with end-stage pulmonary disease. Therefore, postthoracotomy pain therapy is of vital interest. Thoracic epidural analgesia (EPI) is the "gold standard" for postthoracotomy pain, but especially in lung transplantation contraindications, and potential infectious complications limit its advantages. Under these circumstances surgically placed postthoracotomy catheter-assisted continuous paravertebral intercostal nerve block (PVB) could be of advantage...
April 4, 2016: Thoracic and Cardiovascular Surgeon
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