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Paravertebral analgesia

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https://www.readbyqxmd.com/read/29327462/propensity-score-matched-outcomes-after-thoracic-epidural-or-paravertebral-analgesia-for-thoracotomy
#1
W J Blackshaw, A Bhawnani, S H Pennefather, O Al-Rawi, S Agarwal, M Shaw
It is not known which regional analgesic technique is most effective or safest after open lung resection. We retrospectively examined outcomes in 828 patients who received thoracic epidural analgesia and 791 patients who received paravertebral block after lung resection between 2008 and 2012. We analysed outcomes for 648 patients, 324 who had each analgesic technique, matched by propensity scores generated with peri-operative data. There were 22 out of 324 (7%) postoperative respiratory complications after thoracic epidural and 23 out of 324 (7%) after paravertebral block, p = 0...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29327341/combined-thoracic-paravertebral-and-pectoral-nerve-blocks-for-breast-surgery-under-sedation-a-prospective-observational-case-series
#2
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29301653/successful-emergency-pain-control-for-posterior-rib-fractures-with-ultrasound-guided-erector-spinae-plane-block
#3
Josh Luftig, Daniel Mantuani, Andrew A Herring, Brittany Dixon, Eben Clattenburg, Arun Nagdev
The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29284840/effect-of-clonidine-as-adjuvant-in-thoracic-paravertebral-block-for-patients-undergoing-breast-cancer-surgery-a-prospective-randomized-placebo-controlled-double-blind-study
#4
Nairita Mayur, Anjan Das, Hirak Biswas, Subinay Chhaule, Surajit Chattopadhyay, Tapobrata Mitra, Sandip Roybasunia, Subrata Kumar Mandal
Background and Aims: Postoperative pain after breast cancer surgery is unavoidable. Thoracic paravertebral block (TPVB), a locoregional anesthetic technique, has been proven successful for postoperative pain management in different thoracic surgical procedures, such as thoracotomy, breast cancer surgeries. Clonidine, an adjuvant, in TPVB may enhance the quality and prolong the duration of analgesia. This prospective study was to evaluate the effectiveness of clonidine; administered with TPVB; in addition to conventional local anesthetic solution...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29242655/evaluation-of-the-role-of-dexmedetomidine-in-improvement-of-the-analgesic-profile-of-thoracic-paravertebral-block-in-thoracic-surgeries-a-randomised-prospective-clinical-trial
#5
Mohamed Elsayed Hassan, Essam Mahran
Background and Aims: Thoracic paravertebral block (TPB) is one of the effective methods for management of post-operative pain in thoracic surgeries. The aim of the study was to evaluate effectiveness of addition of dexmedetomidine to paravertebral block with bupivacaine in improving the postoperative pain relief and pulmonary functions in patients undergoing thoracic surgeries. Methods: A prospective randomized double-blinded study was performed on forty patients scheduled for thoracic surgery...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29226148/transition-from-deep-regional-blocks-toward-deep-nerve-hydrodissection-in-the-upper-body-and-torso-method-description-and-results-from-a-retrospective-chart-review-of-the-analgesic-effect-of-5-dextrose-water-as-the-primary-hydrodissection-injectate-to-enhance
#6
Stanley K H Lam, Kenneth Dean Reeves, An-Lin Cheng
Deep nerve hydrodissection uses fluid injection under pressure to purposely separate nerves from areas of suspected fascial compression, which are increasingly viewed as potential perpetuating factors in recalcitrant neuropathic pain/complex regional pain. The usage of 5% dextrose water (D5W) as a primary injectate for hydrodissection, with or without low dose anesthetic, could limit anesthetic-related toxicity. An analgesic effect of 5% dextrose water (D5W) upon perineural injection in patients with chronic neuropathic pain has recently been described...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29191649/multilevel-thoracic-paravertebral-block-using-ropivacaine-with-without-dexmedetomidine-in-video-assisted-thoracoscopic-surgery
#7
Jianghui Xu, Xiaoyu Yang, Xiaobing Hu, Xiaofeng Chen, Jun Zhang, Yingwei Wang
OBJECTIVES: Thoracic paravertebral block (TPVB) is reported to have advantages in postoperative pain management in unilateral thoracic surgeries. Previous studies have demonstrated that dexmedetomidine could be used as an adjuvant to local anesthetics, with the aim of prolonging the duration of neural blockade. However, little is known about whether such a combination could improve the quality of postoperative analgesia compared with local anesthetic only when TPVB is used for patients undergoing video-assisted thoracoscopic surgery (VATS)...
June 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29189284/the-use-of-liposomal-bupivacaine-in-erector-spinae-plane-block-to-minimize-opioid-consumption-for-breast-surgery-a-case-report
#8
Amanda Kumar, Alina Hulsey, Hector Martinez-Wilson, James Kim, Jeff Gadsden
The erector spinae plane block is a novel interfascial plane block that can provide thoracic and abdominal analgesia. We describe a patient with opioid intolerance scheduled for breast surgery who received an erector spinae plane block with liposomal bupivacaine as well as a supplemental T1 paravertebral block resulting in profound analgesia throughout her postoperative course. This case report demonstrates that use of liposomal bupivacaine in the erector spinae plane block can be successful in providing extended duration postoperative analgesia and minimizing systemic opioid requirements...
November 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29169795/paravertebral-block-for-thoracic-surgery
#9
REVIEW
Francine D'Ercole, Harendra Arora, Priya A Kumar
Local anesthetic injected into a wedge-shaped space lateral to the spinal nerves as they emerge from the intervertebral foramina produces somatosensory and sympathetic nerve blockade effective for anesthesia and for managing pain of unilateral origin from the chest and abdomen. Paravertebral blockade (PVB) is versatile and may be applied unilaterally or bilaterally. Unlike thoracic epidural, the PVB technique may be used to avoid contralateral sympathectomy, thereby minimizing hypotension and leading to better preservation of blood pressure...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29164294/a-novel-technique-of-paravertebral-thoracic-and-preperitoneal-analgesia-enhances-early-recovery-after-oesophagectomy
#10
Stephanie Phillips, Jasmina Dedic-Hagan, d'Arcy Ferris Baxter, H Van der Wall, G L Falk
BACKGROUND: Excellent analgesia following oesophagectomy facilitates patient comfort, early extubation, physiotherapy and mobilisation, reduces post-operative complications and should enhance recovery. Thoracic epidural analgesia (TEA), the gold standard analgesic regimen for this procedure, is often associated with systemic hypotension treated with inotropes or fluid. This may compromise enhanced recovery and be complicated by anastomotic ischaemia or tissue oedema. METHODS: We report a novel analgesic regimen to reduce post-operative inotrope usage...
November 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29033726/ultrasound-guided-multilevel-paravertebral-block-versus-local-anesthesia-for-medical-thoracoscopy
#11
Maha A Abo-Zeid, Mohammad M Elgamal, Asem A Hewidy, Amro A Moawad, Alaa Eldin Adel Elmaddawy
BACKGROUND: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. PURPOSE: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033723/postoperative-pain-management-in-patients-undergoing-thoracoscopic-repair-of-pectus-excavatum-a-retrospective-analysis-of-opioid-consumption-and-adverse-effects-in-adolescents
#12
Ralph Beltran, Giorgio Veneziano, Tarun Bhalla, Brian Kenney, Dmitry Tumin, Bruno Bissonnette, Joseph D Tobias
INTRODUCTION: Although the Nuss procedure provides excellent cosmetic results for the correction of pectus excavatum, the provision of analgesia following such procedures can be challenging. METHODS: The current study retrospectively reviews our experience over a 2.5 year period with thoracic epidural analgesia (TE), paravertebral blockade (PVB), and intravenous opioids delivered via patient-controlled analgesia (PCA) to provide postoperative analgesia. RESULTS: The study cohort included 30 patients (mean age = 15...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033716/transdermal-fentanyl-as-an-adjuvant-to-paravertebral-block-for-pain-control-after-breast-cancer-surgery-a-randomized-double-blind-controlled-trial
#13
Ahmed H Bakeer, Nasr M Abdallah
OBJECTIVE: The aim of this study is to investigate the effect of transdermal fentanyl (TDF) as an adjuvant to paravertebral block (PVB) for pain control after breast cancer surgery. PATIENTS AND METHODS: This randomized, double-blind trial included fifty females with breast cancer scheduled for surgery. They were randomly allocated into one of two equal groups. The TDF group used transdermal fentanyl patches (TFPs) 25 μg/h applied 10 h preoperative then PVB with 20 mL of bupivacaine 0...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28953631/thoracic-paravertebral-regional-anesthesia-for-pain-relief-in-patients-with-breast-cancer-surgery
#14
RANDOMIZED CONTROLLED TRIAL
Lian-Jin Jin, Li-Yong Wen, Yan-Li Zhang, Gang Li, Ping Sun, Xuan Zhou
BACKGROUND: The present study aimed to assess the efficacy and safety of thoracic paravertebral regional anesthesia (TPVBRA) in patients with breast cancer surgery. METHODS: In total, 72 patients undergoing breast cancer surgery were randomly divided into an intervention group and a control group; each group contained 36 subjects. Both groups received TPVBRA with 20 mL 0.25% bupivacaine. In addition, subjects in the intervention group also received an additional 1 μg/kg dexmedetomidine...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28953508/impact-of-regional-anesthesia-on-recurrence-metastasis-and-immune-response-in-breast-cancer-surgery-a-systematic-review-of-the-literature
#15
Oscar Pérez-González, Luis F Cuéllar-Guzmán, José Soliz, Juan P Cata
BACKGROUND AND OBJECTIVES: The perioperative period is critical in the long-term prognosis of breast cancer patients. The use of regional anesthesia, such as paravertebral block (PVB), could be associated with improvements in long-term survival after breast cancer surgery by modulating the inflammatory and immune response associated with the surgical trauma, reducing opioid and general anesthetic consumption, and promoting cancer cells death by a direct effect of local anesthetics. METHODS: A systematic literature search was conducted for studies of patients who received PVB for breast cancer surgery...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28937423/deep-serratus-plane-catheter-for-management-of-acute-postthoracotomy-pain-after-descending-aortic-aneurysm-repair-in-a-morbidly-obese-patient-a-case-report
#16
Renuka M George, Maria Yared, Sylvia H Wilson
Regional procedures for postthoracotomy pain control have classically focused on paravertebral blocks and thoracic epidurals; however, these techniques may be challenging in an increasingly obese population and contraindicated with numerous anticoagulant and antiplatelet agents. While less studied, truncal blocks allow analgesic intervention for this growing patient cohort. This case report describes placement of a deep serratus anterior plane catheter in an intubated, morbidly obese patient with a lumbar drain who failed extubation secondary to acute postthoracotomy pain...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28928578/comparison-of-spinal-anesthesia-and-paravertebral-block-in-inguinal-hernia-repair
#17
Ranjana Khetarpal, Veena Chatrath, Arminder Kaur, Reeta Jassi, Renu Verma
CONTEXT: Inguinal hernia repair (IHR) is a common surgical procedure which can be performed under general, regional, or peripheral nerve block anesthesia. AIM: The aim of our study was to compare the efficacy of paravertebral block (PVB) with spinal anesthesia (SA) for IHR with respect to postoperative analgesia, ambulation, and adverse effects. SETTINGS AND DESIGN: This was a prospective, single-blind randomized controlled trial. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists Class I-II patients of 20-60 years scheduled for IHR were randomized by a computer-generated list into two groups of thirty each, to receive either PVB (Group PVB: at T12-L2 levels, 10 ml of 0...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928572/comparison-of-bupivacaine-plus-magnesium-sulfate-and-ropivacaine-plus-magnesium-sulfate-infiltration-for-postoperative-analgesia-in-patients-undergoing-lumbar-laminectomy-a-randomized-double-blinded-study
#18
Rajib Hazarika, Samit Parua, Dipika Choudhury, Rajesh Kumar Barooah
AIM: The objective of this study was to assess and compare the analgesic duration of local infiltration of bupivacaine plus magnesium sulfate and ropivacaine plus magnesium sulfate for postoperative analgesia in patients undergoing lumbar laminectomy. STUDY DESIGN: A randomized, prospective, double-blinded single hospital, comparative study. METHODS: Sixty adult patients of the American Society of Anesthesiologists physical Status I and II were randomly allocated into two Groups BM and RM, comprising 30 and 31 patients...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28924315/comparison-between-continuous-thoracic-epidural-block-and-continuous-thoracic-paravertebral-block-in-the-management-of-thoracic-trauma
#19
Shalendra Singh, Mathews Jacob, S Hasnain, Mathangi Krishnakumar
BACKGROUND: Postoperative pain is thought to be the single most important factor leading to ineffective ventilation and impaired secretion clearance after thoracic trauma. Effective pain relief can be provided by thoracic epidural analgesia but may have side effects or contraindications. Paravertebral block is an effective alternative method without the side effects of a thoracic epidural. We did this study to compare efficacy of thoracic epidural and paravertebral block in providing analgesia to thoracic trauma patients...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28913488/bilateral-thoracic-paravertebral-nerve-blocks-for-placement-of-percutaneous-radiologic-gastrostomy-in-patients-with-amyotrophic-lateral-sclerosis-a-case-series
#20
Arun Kalava, Steven Clendenen, J Mark McKinney, Elird Bojaxhi, Roy A Greengrass
BACKGROUND AND AIMS: To assess the efficacy of bilateral thoracic paravertebral nerve blocks (PVB) in providing procedural anesthesia and post-procedural analgesia for placement of percutaneous radiologic gastrostomy tubes (PRG) in patients with amyotrophic lateral sclerosis (ALS). METHODS: We prospectively observed 10 patients with ALS scheduled for PRG placement that had bilateral thoracic PVBs at thoracic 7, 8, and 9 levels with administration of a mixture of 3 mL of 1% ropivacaine, 0...
October 2016: Romanian Journal of Anaesthesia and Intensive Care
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