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Paravertebral analgesia

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
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
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 Clin Rep
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
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
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
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
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
Harsha Shanthanna, Peter Moisuik, Turlough O'Hare, Sadeesh Srinathan, Christian Finley, James Paul, Peter Slinger
OBJECTIVES: To determine the preferences and perceptions regarding analgesic options for video-assisted thoracic surgery (VATS) among thoracic anesthesiologists in Canada. DESIGN: A cross-sectional survey of thoracic anesthesiologists with 30 multiple choice questions was e-mailed through an online survey tool called FluidSurveys was performed to members of the Canadian Anesthesiologists' Society. SETTING: A nationwide survey. PARTICIPANTS: Members of Canadian Anesthesiologists' Society who provide thoracic anesthesia INTERVENTIONS: None...
January 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Takahiro Tamura, Kana Kitamura, Shuichi Yokota, Shigeki Ito, Yasuyuki Shibata, Kimitoshi Nishiwaki
BACKGROUND AND OBJECTIVES: Several types of quadratus lumborum block (QLB) are used for postoperative analgesia and are believed to be effective against both somatic and visceral pain via a local anesthetic (LA) effect in the paravertebral space (PVS). However, it remains unclear whether all QLB techniques result in LA spread into the PVS. We hypothesized that LA administered via intramuscular QLB would spread into the paravertebral space and investigated the spread and sensory block area of LA in intramuscular QLB...
January 31, 2018: Regional Anesthesia and Pain Medicine
Christian Bauer, Isabelle Pavlakovic, Catherine Mercier, Jean-Michel Maury, Catherine Koffel, Pascal Roy, Jean-Luc Fellahi
BACKGROUND: The benefit of adding opioid to a local anaesthetic for continuous thoracic paravertebral analgesia after video-assisted thoracic surgery (VATS) is unclear. OBJECTIVES: To analyse the analgesic efficacy of ropivacaine and sufentanil in combination compared with ropivacaine alone after VATS. DESIGN: A randomised, double-blinded, single-centre clinical trial. SETTING: A tertiary university hospital between March 2010 and April 2014...
January 25, 2018: European Journal of Anaesthesiology
C Gaio-Lima, C C Costa, J B Moreira, T S Lemos, H L Trindade
Erector spinae plane block has been recently described and it appears as a very promising regional analgesia technique. We report the first continuous erector spinae plane block performed in a pediatric patient for thoracic surgery. A 15-month-old boy, diagnosed with a paracardiac teratoma was scheduled for a tumor resection with a thoracotomy approach. After general anesthesia induction, a continuous erector spinae plane block at T5 level was performed with ropivacaine 0.2%. After surgery, a continuous thoracic interfascial infusion of ropivacaine 0...
January 19, 2018: Revista Española de Anestesiología y Reanimación
Ahmad Bakhtiar Md Radzi, Soek-Siam Tan
RATIONALE: We report a rare case of hepatocellular carcinoma (HCC) with metastases to the mandible and coracoid process of scapula without evidence of lung involvement. PATIENTS CONCERNS: The patient was diagnosed with HCC, presented 5 months later with right lower tooth pain, swelling over the right mandible area and right shoulder pain. DIAGNOSES: Histopathological examination of mandible showed findings suggestive of metastatic HCC. Magnetic resonance imaging (MRI) of the right shoulder revealed findings of irregular enhancing lesion at the right coracoid process causing erosion of the coracoid process...
January 2018: Medicine (Baltimore)
Karen Boretsky, Maria A Hernandez, Elizabeth Eastburn, Cornelius Sullivan
BACKGROUND: The clinical reliability and reproducibility of ultrasound-guided lumbar plexus blocks is not established in pediatric populations. We present the results of a combined nerve stimulation ultrasound-guided lumbar plexus block using the vertebral body, transverse process, and psoas muscle as landmarks on a transverse lumbar paravertebral sonogram with mid-axillary transducer placement, "shamrock method," in children and adolescents. AIMS: Our primary objective was to determine the rate of achieving sensory changes in the lumbar plexus distribution...
January 23, 2018: Paediatric Anaesthesia
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
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
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
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
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
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
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