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Paravertebral analgesia

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https://www.readbyqxmd.com/read/28740682/combined-analgesic-treatment-of-epidural-and-paravertebral-block-after-thoracic-surgery
#1
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In pulmonary surgical practice, appropriate pain management after thoracotomy is essential for patient recovery and the prevention of complications. Although epidural analgesia (EPI) has been established for chest surgery, it has some limitations and contraindications. Recently, paravertebral block (PVB) was reported as a good alternative method with fewer side effects. Despite the significant effects of these two treatments, postoperative pain remains among the greatest patient burdens. In our institution, we apply a combination of epidural and PVBs after thoracic surgery to reduce pain more effectively...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#2
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#3
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28665874/single-injection-versus-multiple-injection-technique-of-ultrasound-guided-paravertebral-blocks-a-randomized-controlled-study-comparing-dermatomal-spread
#4
Vishal Uppal, Rakesh V Sondekoppam, Parvinder Sodhi, David Johnston, Sugantha Ganapathy
BACKGROUND AND OBJECTIVES: The objective of this study was to investigate the extent of dermatomal spread following an ultrasound-guided thoracic paravertebral block (PVB) when equal volumes of local anesthetic are injected at 1 versus 5 vertebral levels. METHODS: Seventy patients undergoing a unilateral mastectomy were randomized to receive either single or multiple injections of a PVB under real-time ultrasound guidance using a parasagittal approach. The patients in the single-injection group received a PVB at T3-T4 level with 25 mL of 0...
June 29, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28664348/paravertebral-blocks-for-same-day-breast-surgery
#5
REVIEW
Mark R Jones, Graham R Hadley, Alan D Kaye, Philipp Lirk, Richard D Urman
PURPOSE OF REVIEW: Breast surgery, performed for medical or cosmetic reasons, remains one of the most frequently performed procedures, with over 500,000 cases performed annually in the USA alone. Historically, general anesthesia (GA) has been widely accepted as the gold-standard technique, while epidural anesthesia was largely considered too invasive and thus unnecessary for breast surgery. Over the past years, paravertebral block (PVB) has emerged as an alternative analgesic or even anesthetic technique...
August 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28663622/comparative-evaluation-of-continuous-thoracic-paravertebral-block-and-thoracic-epidural-analgesia-techniques-for-post-operative-pain-relief-in-patients-undergoing-open-nephrectomy-a-prospective-randomized-single-blind-study
#6
Sujeet Kumar Singh Gautam, Pravin Kumar Das, Anil Agarwal, Sanjay Kumar, Sanjay Dhiraaj, Abhishek Keshari, Abinash Patro
BACKGROUND: Open surgical procedures are associated with substantial postoperative pain; an alternative method providing adequate pain relief with minimal side effects is very much required. AIM: The aim of this study was a comparative evaluation of the efficacy of continuous thoracic paravertebral block (PVB) and thoracic epidural analgesia (EA) for postoperative pain relief in patients undergoing open nephrectomy. SETTINGS AND DESIGN: Prospective, randomized, and single-blind study...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28635359/thoracic-paravertebral-block-versus-intravenous-patient-controlled-analgesia-for-pain-treatment-in-patients-with-multiple-rib-fractures
#7
Ge Yeying, Yuan Liyong, Chen Yuebo, Zhang Yu, Ye Guangao, Ma Weihu, Zhao Liujun
Objectives To assess the effect of thoracic paravertebral block (PVB) on pain management and preservation of pulmonary function compared with intravenous, patient-controlled analgesia (IVPCA) in patients with multiple rib fractures (MRFs). Methods Ninety patients with unilateral MRFs were included in this prospective study and randomly assigned to the TPVB or IVPCA group. The visual analogue scale (VAS) pain score, blood gas analysis, and bedside spirometry were measured and recorded at different time points after analgesia...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28631050/analgesia-nociception-index-ani-monitoring-in-patients-with-thoracic-paravertebral-block-a-randomized-controlled-study
#8
Nurseda Dundar, Alparslan Kus, Yavuz Gurkan, Kamil Toker, Mine Solak
The goal of the study was to evaluate the effectiveness of analgesia nociception index (ANI) monitoring during intraoperative period for patients with thoracic paravertebral block (TPVB) undergoing breast surgery under general anesthesia. This prospective randomized trial was performed after receiving ethics committee approval in 44 patients who were scheduled to undergo breast surgery under general anesthesia. TPVB was performed in the preoperative period using 20 mL of bupivacaine 0.25% at T4 level. Anesthesia maintenance was provided with sevoflurane in O2: air mixture and remifentanil infusion...
June 19, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28614112/serratus-anterior-plane-block-to-address-postthoracotomy-and-chest-tube-related-pain-a-report-on-3-cases
#9
George M Chu, G Craig Jarvis
In this case report, the serratus anterior plane block was used in conjunction with multilevel continuous thoracic paravertebral blocks (TPVB) and general anesthesia in 3 thoracotomy cases. All blocks were accompanied by use of catheters that allowed continuous local anesthetic infusions and intermittent local anesthetic bolus injections to address postoperative pain. In all 3 patients, the serratus anterior plane block provided analgesia for chest tube-related pain that was not provided by the TPVB alone.
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28601480/the-trajectory-of-postoperative-pain-following-mastectomy-with-and-without-paravertebral-block
#10
Rochelle Wynne, Natalie Lui, Kristen Tytler, Carol Koffsovitz, Victor Kirwa, Bernhard Riedel, Shane Ryan
Evidence to support the argument that general anesthesia (GA) with paravertebral block (PVB) provides better pain relief for mastectomy patients than GA alone is contradictory. The aim of this study was to explore pain and analgesia after mastectomy with or without PVB during acute inpatient recovery. A retrospective study was conducted in a single hospital providing specialist cancer services in metropolitan Melbourne, Australia. We explored pain and concomitant analgesic administration in 80 consecutive women recovering from mastectomy who underwent GA with (n = 40) or without (n = 40) PVB...
June 7, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28592166/continuous-bilateral-thoracic-paravertebral-blockade-for-analgesia-after-cardiac-surgery-a-randomised-controlled-trial
#11
Geoff G Lockwood, Leilani Cabreros, Dorota Banach, Prakash P Punjabi
BACKGROUND: Continuous bilateral thoracic paravertebral blockade has been used for analgesia after cardiac surgery, but its efficacy has never been formally tested. METHOD: Fifty adult patients were enrolled in a double-blind, randomised, controlled study of continuous bilateral thoracic paravertebral infusion of 0.5% lidocaine (1 mg.kg(-1).hr(-1)) for analgesia after coronary surgery. Control patients received a subcutaneous infusion of lidocaine at the same rate through catheters inserted at the same locations as the study group...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28584346/analgesic-efficacy-of-ultrasound-guided-paravertebral-block-versus-serratus-plane-block-for-modified-radical-mastectomy-a-randomised-controlled-trial
#12
Kapil Gupta, Kadapa Srikanth, Kiran Kumar Girdhar, Vincent Chan
BACKGROUND AND AIMS: Modified radical mastectomy (MRM) may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB) and serratus plane block (SPB). METHODS: This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28557058/thoracic-paravertebral-blockade-in-breast-surgery-is-pneumothorax-an-appreciable-concern-a-review-of-over-1000-cases
#13
Michael E Kelly, Daniel Mc Nicholas, James Killen, Joey Coyne, Karl J Sweeney, John McDonnell
There has been a substantial increase in ambulatory day-case breast surgery in recent decades. This has been largely due to improvements in anesthetic procedures and pre-emptive analgesia. Thoracic paravertebral blockade (TPVB) is increasing in popularity, though concerns over iatrogenic injury remain, especially pneumothorax. The purpose of this study was to conduct a review of the incidence of pneumothorax following TPVB prior to breast surgery. Data from of a consecutive series of patients having TPVB prior to breast surgery between 2009 and 2014 were reviewed...
May 30, 2017: Breast Journal
https://www.readbyqxmd.com/read/28549524/-quadratus-lumborum-block-are-we-aware-of-its-side-effects-a-report-of-2-cases
#14
Miguel Sá, José Miguel Cardoso, Hugo Reis, Marta Esteves, José Sampaio, Isabel Gouveia, Pilar Carballada, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: The quadratus lumborum block was initially described in 2007 and aims at blocking the same nerves as the ones involved on the Transverse Abdominis Plane block, while accomplishing some visceral enervation as well due to closer proximity with the neuroaxis and sympathetic trunk. Given its versatility, we have successfully used it in a wide range of procedures. We report two cases where we believe the dispersion of local anesthetic is likely to have led to a previously undescribed complication...
May 23, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28526487/ultrasound-guided-thoracic-paravertebral-injection-in-dogs-a-cadaveric-study
#15
Diego A Portela, Luis Campoy, Pablo E Otero, Manuel Martin-Flores, Robin D Gleed
OBJECTIVE: To describe ultrasound-visualized anatomy and the spread characteristics of a dye injected in the thoracic paravertebral (TPV) space under ultrasound guidance. STUDY DESIGN: Anatomic cadaver study. ANIMALS: Seven dog cadavers. METHODS: One cadaver was used to observe, identify, and describe the relevant TPV anatomy. In the remaining six, the left fifth TPV space was randomly assigned to be injected with either a low volume (LV; 0...
February 16, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28526464/-transient-horner-s-syndrome-after-single-shot-paravertebral-block
#16
Birzat Emre Gölboyu, Mürsel Ekinci, Pınar Karaca Baysal, Ayşe Nur Yeksan, Erkan Cem Çelik, Zeynep Bilgi, Murat Aksun
BACKGROUND: Thoracic paravertebral block can provide analgesia for unilateral chest surgery and is associated with a low complication rate. Horner syndrome also referred to as oculosympathetic paresis, is a classic neurologic constellation of ipsilateral blepharoptosis, pupillary miosis, and facial anhidrosis resulting from disruption of the sympathetic pathway supplying the head, eye, and neck. CASE REPORT: We present a patient with an ipsilateral transient Horner syndrome after ultrasound guided single shot of 15mL 0...
May 17, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28525509/analgesic-choice-in-management-of-rib-fractures-paravertebral-block-or-epidural-analgesia
#17
Mahdi Malekpour, Ammar Hashmi, James Dove, Denise Torres, Jeffrey Wild
BACKGROUND: Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB). METHODS: Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures. Primary outcome was in-hospital mortality...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28509780/hypnosis-and-axillary-compartment-block-for-breast-cancer-surgery-a-case-report
#18
Régis Fuzier, Sylviane Achelous, Geneviève Salvignol, Eva Jouve
Hypnosis has been proven to be a powerful tool in the management of anxiety and pain. It allows for an increase of pain threshold, which can reach the level of surgical analgesia. Recently injection of local anesthetics around the serratus muscle has been presented as an alternative to paravertebral block for cancer breast surgery. We report the successful use of hypnosis in combination with an axillary compartment block for lumpectomy and axillary lymph node dissection.
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28489642/pupillary-reflex-for-evaluation-of-thoracic-paravertebral-block-a-prospective-observational-feasibility-study
#19
Baptiste Duceau, Mélanie Baubillier, Gaëlle Bouroche, Aline Albi-Feldzer, Christian Jayr
BACKGROUND: Although thoracic paravertebral block (TPVB) is recommended in major breast surgery, there is no gold standard to assess the success of TPVB. Pupillary dilation reflex (PDR) is the variation of the pupillary diameter after a noxious stimulus. The objective was to evaluate the feasibility of recording the PDR to assess analgesia in an anesthetized thoracic dermatome after TPVB. METHODS: This prospective, observational, single-center study included 32 patients requiring breast surgery under general anesthesia and TPVB...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28455601/paravertebral-block-catheter-breakage-by-electrocautery-during-thoracic-surgery
#20
Noboru Saeki, Yuki Sugimoto, Yoko Mori, Takahiro Kato, Hirotsugu Miyoshi, Ryuji Nakamura, Tomomichi Koga
Advantages of thoracic paravertebral analgesia (TPA) include placement of the catheter closer to the surgical field; however, the catheter can become damaged during the operation. We experienced a case of intraoperative TPA catheter breakage that prompted us to perform an experiment to investigate possible causes. A 50-year-old male underwent a thoracoscopic lower lobectomy under general anesthesia with TPA via an intercostal approach. Following surgery, it was discovered that the catheter had become occluded, as well as cut and fused, so we reopened the incision and removed the residual catheter...
June 2017: Journal of Anesthesia
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