Bilateral paravertebral block: a satisfactory alternative for labour analgesia

Nair, Vinod; Henry, Ronald J. W.

doi:10.1007/bf03019732

Cited by 19 publications

(14 citation statements)

References 24 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The major advantage of paravertebral nerve blocks is that analgesia can be provided in patients for whom neuraxial analgesia could be complicated, such as neuraxial anatomical abnormalities or spine surgery with instrumentation 18. For non-incisional (visceral) pain after cesarean delivery, the paravertebral block of sympathetic chain ganglion offers unique advantages to other abdominal wall blocks that only target cutaneous nerves.…”

Section: Lumbar Paravertebral Blockmentioning

confidence: 99%

A review of peripheral nerve blocks for cesarean delivery analgesia

Mitchell

Smith

Mechling

et al. 2019

Reg Anesth Pain Med

View full text Add to dashboard Cite

Peripheral nerve blocks have a unique role in postcesarean delivery multimodal analgesia regimens. In this review article, options for peripheral nerve blocks for cesarean delivery analgesia will be reviewed, specifically paravertebral, transversus abdominis plane, quadratus lumborum, iliohypogastric and ilioinguinal, erector spinae, and continuous wound infiltration blocks. Anatomy, existing literature evidence, and specific areas in need of future research will be assessed. Considerations for local anesthetic toxicity, and for informed consent for these modalities in the context of emergency cesarean deliveries, will be presented.

show abstract

Section: Lumbar Paravertebral Blockmentioning

confidence: 99%

A review of peripheral nerve blocks for cesarean delivery analgesia

Mitchell

Smith

Mechling

et al. 2019

Reg Anesth Pain Med

View full text Add to dashboard Cite

show abstract

“…Unilateral paravertebral [4] and intrapleural [5] analgesia have also been used in minimally invasive direct coronary artery bypass (MIDCAB) surgery. Bilateral paravertebral blockade has been used successfully in abdominal vascular surgery [6], after bilateral thoracotomy in children [7], after bilateral thoracoscopic surgery [8] and for obstetric analgesia [9]. In this study, we evaluated the feasibility of continuous bilateral paravertebral blockade in combination with general anaesthesia for ‘on‐pump’ cardiac surgery.…”

mentioning

confidence: 99%

Bilateral paravertebral blockade for conventional cardiac surgery

et al. 2003

View full text Add to dashboard Cite

SummaryWe conducted a postal survey of cardiac anaesthetists in the UK, to determine the extent of magnesium sulphate (MgSO 4 ) use and the main indications for its administration. Questionnaires were sent to anaesthetists at 35 UK hospitals undertaking adult cardiac surgery. Responses were received from 24 hospitals (69%) totalling 124 individual responses. Twenty-five (20%) of the anaesthetists responding to the questionnaire routinely gave magnesium other than in cardioplegia. The most common indications for administration were arrhythmia prophylaxis and treatment, myocardial protection and the treatment of hypomagnesaemia.Keywords Anaesthesia; cardiovascular. Heart; arrhythmia, prevention. Ions; magnesium. Magnesium deficiency is common in hospitalised patients [1]. It may be related to diuretic and beta-blocker therapy, and is more common in the cardiac surgical population [2, 3]. Hypomagnesaemia is common following cardiopulmonary bypass (CPB), and persists into the postoperative period [4]. It is associated with a higher incidence of arrhythmias and a low cardiac index [2]. However, the routine administration of magnesium sulphate during cardiac surgery remains controversial. Several studies support its routine administration for arrhythmia prophylaxis [5][6][7][8], whereas others oppose this view [9, 10] and even suggest a detrimental effect from magnesium administration [11]. This survey was conducted to investigate the attitudes and current practice of cardiac anaesthetists in the UK to the routine administration of magnesium sulphate. MethodsFollowing approval from the Association of Cardiothoracic Anaesthetists (ACTA), postal questionnaires (Appendix) were sent to the ACTA contact in 35 adult cardiac surgery centres for distribution to consultant anaesthetists. The questionnaire was designed to examine the incidence of routine magnesium sulphate use, the dose and timing of its administration, the indications for its use, the frequency of serum magnesium measurements and the reasons for avoiding its routine use. ResultsReplies were received from 24 (69%) hospitals. A total of 124 individual questionnaires were completed. Of these, 25 (20%) of anaesthetists routinely administered magnesium sulphate.Of those who gave magnesium routinely, 76% administered it during CPB. The most common dose used was a 2-4 g (8-16 mmol) bolus. The main indications were arrhythmia prophylaxis, myocardial protection and suspected hypomagnesaemia associated with hypokalaemia and diuretic therapy. Several respondents commented on its usefulness in patients with poor left ventricular function and a reduction in inotropic support requirements post CPB.Thirty-six per cent of anaesthetists administer magnesium post CPB (24% during and post CPB), mainly as a bolus of 2-4 g. Indications given are arrhythmia prophylaxis and treatment, and measured hypomagnesaemia.Thirty-two per cent of anaesthetists administer it pre-CPB. A larger bolus dose of 5 g is most frequently given. The numerous indications stated include arrhythmia Anaesth...

show abstract

“…The risk of spinal haematoma should be negligible with the use of paravertebral block 8 9 -a technique that has been used for pain relief after liver 12 and chest 13 trauma, in labour, 14 after thoracotomy 15 and in inguinal, 16 breast, 17 cardiac 18 and vascular 19 surgery. Bleeding into the non-compressible thoracic paravertebral space is nonetheless of concern, especially when the technique is associated with vascular puncture in 3.8% of cases.…”

Section: Discussionmentioning

confidence: 99%