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Paravertebral nerve catheter

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
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
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
Kanako Hiro, Tomohiro Sugiyama, Masashi Kurata, Yumiko Oi, Masahiro Okuda
BACKGROUND: Epidural analgesia or paravertebral block is widely used in postoperative analgesia for video-assisted thoracic surgery (VATS). We investigated the efficacy of the continuous intravenous infuion of fentanyl combined with intercostal nerve block, in comparison with the continuous epidural analgesia. METHODS: Forty-one patients received a bolus of 0.375% ropivacaine 6-10 ml through the epidural catheter placed at the T5-9 at the end of surgery. Then, continuous epidural infusion of 0...
February 2016: Masui. the Japanese Journal of Anesthesiology
Amber D Shaffer, Noel Jabbour, Mihaela Visoiu, Charles I Yang, Robert F Yellon
Acute Interventional Perioperative Pain Service consultants have routinely placed paravertebral nerve block (PVB) catheters for the continuous release of ropivacaine following stage I microtia reconstruction with costal cartilage graft at our institution since 2010. A retrospective chart review from July 2006 was performed to compare the length of hospital stay, median pain score (0-10 scale), and opioid use of patients receiving PVB with those of historical controls. Statistical analysis included t, Mann-Whitney U, and Fisher's exact tests...
May 2016: Otolaryngology—Head and Neck Surgery
Mihaela Visoiu
PURPOSE OF REVIEW: Effective analgesia is necessary for optimal recovery after surgery, but children often do not attain adequate postoperative pain control. This review examines the current trends in paediatric regional anaesthesia. RECENT FINDINGS: Better pain assessment and therapeutic regimens are needed for our patients. Trunk blocks such as paravertebral, transversus abdominis plane, rectus sheath and ilioinguinal/iliohypogastric are becoming a popular means of providing analgesia for thoracic and abdominal procedures...
October 2015: Current Opinion in Anaesthesiology
Sigrid Bairdain, Brenda Dodson, David Zurakowski, David B Waisel, Russell W Jennings, Karen R Boretsky
BACKGROUND: Infants with long-gap esophageal atresia (LGEA) undergo repeated thoracotomies for staged surgical repair known as the Foker process (FP). Associated prolonged mechanical ventilation results in exposure to high doses of opioids and benzodiazepines, and prolonged weaning times and ICU stays. AIM: The aim of this study was to determine the effectiveness of short-term paravertebral nerve block (PVNB) catheters in reducing opioid/benzodiazepine exposure and effects on clinical variables...
November 2015: Paediatric Anaesthesia
Gabor Kiss, Maria Castillo
Performing awake thoracic surgery (ATS) is technically more challenging than thoracic surgery under general anesthesia (GA), but it can result in a greater benefit for the patient. Local wound infiltration and lidocaine administration in the pleural space can be considered for ATS. More invasive techniques are local wound infiltration with wound catheter insertion, thoracic wall blocks, selective intercostal nerve blockade, thoracic paravertebral blockade and thoracic epidural analgesia, offering the advantage of a catheter placement which can also be continued for postoperative analgesia...
May 2015: Annals of Translational Medicine
Elif Dogan Baki, Gürhan Öz, Serdar Kokulu, Alper Murat Ulaşlı, Yüksel Ela, Remziye Gul Sıvacı, Hasan Şenay, Gökcen Doğan
BACKGROUND: Inadequate relief of postthoracotomy pain is a major reason of increased occurrence of postoperative complications. We aimed to investigate and compare the effects of transcutaneous electrical nerve stimulation (TENS) and paravertebral block (PVB) to relieve pain after thoracotomy procedures. MATERIALS AND METHODS: We studied 40 patients who underwent thoracotomy. Patients were randomly allocated to receive either PVB (group P, n = 20) or TENS (group T, n = 20) for postoperative pain...
September 2015: Thoracic and Cardiovascular Surgeon
Susan M Moeschler, Casandra Rosenberg, Drew Trainor, Richard H Rho, W David Mauck
Cancer-related pain is a significant cause of morbidity in those affected by both primary and metastatic disease. Although oral, transdermal, and parenteral opioid medications are an integral part of the World Health Organization's analgesic ladder, their use may be limited by side effects. Fortunately, there are advanced interventional pain management strategies effective in reducing pain in the cancer patient while mitigating the aforementioned side effects. Celiac plexus blocks and neurolysis have been proven effective in treating cancers of the abdominal viscera (ie, pancreas)...
December 2014: Hospital Practice (Minneapolis)
Brian M Ilfeld, Sarah J Madison, Preetham J Suresh, NavParkash S Sandhu, Nicholas J Kormylo, Nisha Malhotra, Vanessa J Loland, Mark S Wallace, Edward J Mascha, Zekun Xu, Cindy H Wen, Anya C Morgan, Anne M Wallace
BACKGROUND: In a previous randomized, triple-masked, placebo-controlled study, the authors demonstrated that extending a single-injection paravertebral nerve block with a multiple-day perineural local anesthetic infusion improves analgesia and decreases pain-related dysfunction during the 3-day infusion but not subsequent to catheter removal within 1 month after mastectomy. This report describes a prospective follow-up study of the previously published trial to investigate the possibility that extending a single-injection paravertebral block with a multiple-day infusion may decrease persistent postsurgical pain as well as pain-induced emotional and functional dysfunction 1 year after mastectomy...
2015: Annals of Surgical Oncology
Mihaela Visoiu, Lendi N Joy, Jan S Grudziak, Jacques E Chelly
BACKGROUND: Ambulatory continuous peripheral nerve blocks (CPNBs) are feasible for pediatric patients. We sought to evaluate the efficacy of CPNBs in a pediatric population. METHODS: This retrospective report of 33-month prospectively collected data investigates patient, parent, and nurse pain control satisfaction score (PCSS), the incidence and severity of pain, daily analgesic consumption following discharge home with various CPNBs and On-Q pumps, and any complications and side effects related to CPNBs...
November 2014: Paediatric Anaesthesia
Karen R Boretsky
PURPOSE OF REVIEW: This review highlights new data and current trends of well tolerated and effective paediatric regional anesthesia. Historically, the practice of paediatric regional anesthesia was based largely on information from adult studies, but recent literature contains information on paediatric specific risks and benefits of old and new techniques as well as the impact of new ideas and technologies. RECENT FINDINGS: Excellent pain relief with regional anesthesia is well demonstrated in children...
October 2014: Current Opinion in Anaesthesiology
Federico Piccioni, Luca Fumagalli, Francesco Garbagnati, Giuseppe Di Tolla, Vincenzo Mazzaferro, Martin Langer
STUDY OBJECTIVE: To present our preliminary experience using a thoracic paravertebral block (TPVB) as the sole anesthetic in percutaneous hepatic radiofrequency ablation (RFA). DESIGN: Retrospective case series of 12 ASA physical status 1, 2, and 3 patients of average risk scheduled for RFA. SETTING: University medical center. MEASUREMENTS: The first 12 procedures performed using TPVB were analyzed to evaluate the efficacy and safety of this anesthetic technique...
June 2014: Journal of Clinical Anesthesia
Mihaela Visoiu
Outpatient pain management after iliac crest bone harvesting can be challenging. We report the use of home L2 paravertebral nerve block catheter (L2PVBC) in a series of five children. The pain scores were low, and analgesic medication consumption was minimal. No complications were reported related with these catheters, and the patients reported very high pain control satisfaction scores. Outpatient L2PVBC can be beneficial as part of a multimodal analgesia strategy in selected pediatric patients.
August 2014: Paediatric Anaesthesia
Alessandra Di Pede, Francesco Morini, Mary H Lombardi, Stefania Sgrò, Raoul Laviani, Andrea Dotta, Sergio G Picardo
BACKGROUND: In infants, post-thoracotomy analgesia traditionally consists of systemic opiates, while regional techniques have gained more favor in recent years. We compare the two techniques for thoracotomy in infants. METHODS: All consecutive patients below 6 months of age who underwent thoracotomy for congenital pulmonary malformations in the study period were retrospectively divided according to the chosen postoperative analgesia: Group S systemic opiates, Group R continuous regional (epidural or extrapleural paravertebral) block...
June 2014: Paediatric Anaesthesia
Denise M Hall Burton, Karen R Boretsky
INTRODUCTION: Thoracic epidurals (TE) have been advocated as a superior method for controlling postoperative pain after repair of pectus excavatum with a Nuss procedure. However, three recent reports of permanent neurologic injury after the Nuss procedure with concurrent TE analgesia have raised concerns about the safety of this combination. Paravertebral nerve blocks (PVNB) are used successfully for analgesia of the chest, but no studies are available comparing TE and PVNB catheters for postoperative analgesia in this patient population...
May 2014: Paediatric Anaesthesia
Emile Calenda, Jean Marc Baste, Ridha Hajjej, Eric Danielou, Christophe Peillon
A case of systemic ropivacaine toxicity from a continuous thoracic paravertebral block in an adult patient who received a lobectomy is presented. The catheter was placed by the surgeon. Eleven hours after the start of the infusion, the patient experienced an arrhythmia leading to death. The total venous plasma concentration of ropivacaine was high (3.2 μg/mL). Furthermore, the patient had severe hypoalbuminemia (albumin 24 g/L), which resulted in the increase of the unbound ropivacaine plasma concentration that was responsible for the toxic side effects...
March 2014: Journal of Clinical Anesthesia
Li-xin Sun, Li Cong, Ming-shan Wang, Fei Shi
OBJECTIVE: To investigate the feasibility of bilateral thoracic paravertebral block for postoperative analgesia in patients after off-pump coronary artery bypass grafting (OPCABG). METHODS: Upon the approval of institutional Ethics Committee and informed consent, forty patients ASAII or III aged 52-77 yr with BMI (body mass index) < 30 kg/m(2), undergoing OPCABG, were randomly divided by random numbers into two groups(n = 20 each):thoracic paravertebral block for postoperative analgesia group (group P) and patient-controlled intravenous analgesia (PCIA) group (group I)...
December 3, 2013: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Brian M Ilfeld, Sarah J Madison, Preetham J Suresh, Navparkash S Sandhu, Nicholas J Kormylo, Nisha Malhotra, Vanessa J Loland, Mark S Wallace, James A Proudfoot, Anya C Morgan, Cindy H Wen, Anne M Wallace
BACKGROUND: We aimed to determine with this randomized, triple-masked, placebo-controlled study if benefits are afforded by adding a multiple-day, ambulatory, continuous ropivacaine paravertebral nerve block to a single-injection ropivacaine paravertebral block after mastectomy. METHODS: Preoperatively, 60 subjects undergoing unilateral (n = 24) or bilateral (n = 36) mastectomy received either unilateral or bilateral paravertebral perineural catheter(s), respectively, inserted between the third and fourth thoracic transverse process(es)...
March 2014: Regional Anesthesia and Pain Medicine
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